Neuropediatrics 2020; 51(06): 421-424
DOI: 10.1055/s-0040-1708547
Short Communication

Acute Cerebellitis and Atypical Posterior Reversible Encephalopathy Syndrome Associated with Methadone Intoxication

1  Department of Pediatric Hospital Medicine, Dayton Children's Hospital, Dayton, Ohio, United States
,
Irma Reyes
2  Department of Pediatric Neurology, Dayton Children's Hospital, Dayton, Ohio, United States
,
Elizabeth Ey
3  Department of Pediatric Radiology, Dayton Children's Hospital, Dayton, Ohio, United States
,
Dustin Mayne
4  Pediatric Resident PGY-3, Dayton Children's Hospital, Dayton, Ohio, United States
,
Kristen White
5  Pediatric Resident PGY-2, Dayton Children's Hospital, Dayton, Ohio, United States
› Author Affiliations
Funding Source No funding was secured for this article.

Abstract

We report a case of a 9-year-old boy who presented with altered mental status and ataxia following 3 days of vomiting. Shortly after arrival to our emergency department, he declined and required intubation. The following day, he recovered and was successfully extubated. He was found to be positive for methadone on his urine drug screen. Brain imaging demonstrated a pattern of acute cerebellitis. Following extubation, the patient returned to his normal mental status; however, he began to have consistently elevated blood pressure and bradycardia and subsequent brain imaging showed supratentorial changes that were related to atypical posterior reversible encephalopathy syndrome. Through medical management including high-dose steroids and antihypertensive medications, the patient's blood pressure normalized, and he was eventually discharged home without further complications.

Contributors

S.S. wrote the manuscript. I.R. reviewed it and contributed to the “Discussion.” E.E. reviewed the manuscript, provided and commented on the images. D.M. and K.W. drafted the initial “The Case.”


Financial Disclosure

The authors have no financial relationships relevant to this article to disclose.




Publication History

Received: 22 May 2019

Accepted: 31 January 2020

Publication Date:
20 March 2020 (online)

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