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Images in paediatrics
Acute necrotising encephalopathy of childhood: an uncommon cause of childhood encephalopathy with recognisable clinical and radiological features and genetic predisposition
  1. Nicholas Schindler,
  2. Gautam Ambegaonkar
  1. Child Development Centre, Addenbrooke's Hospital
  1. Correspondence to Dr Gautam Ambegaonkar, Child Development Centre, P. O. Box 107, Addenbrooke's Hospital; gautam.ambegaonkar{at}

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A previously healthy 7-year-old girl presented with altered sensorium and agitation following an upper respiratory tract illness. She became encephalopathic with dyskinesia and bilateral VI nerve palsy. She was treated with intravenous antibiotics and acyclovir for presumed meningoencephalitis and transferred to the regional neurology centre. MRI brain showed bilateral lesions in the thalami (figures 1 and 2) and dorsal pons with surrounding oedema. Acute disseminated encephalomyelitis was considered unlikely due to the site and …

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  • Contributors NS reviewed the literature of the case, obtained the images and wrote the text. GA edited the text and obtained written consent from the parents.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.