Dr. Sujatha Thyagarajan, Sr Consultant and Lead - Paediatrics and Paediatric Intensive Case, Aster RV Hospital
BENGALURU: In a rare case, doctors at Aster RV Hospital treated a 1-year-old baby suffering from post-Covid Hemiconvulsion-Hemiplagia-Epilepsy syndrome (HHES), a rare post-Covid complication that led to multiple episodes of seizures and paralysis on the right side of the child’s body. Children affected with Covid-19 largely display mild symptoms however in some cases it is possible for children to develop MIS-C, a complication that leads to inflammation in different organs of the child’s body. HHES is a very rare manifestation of MIS-C.
1-year-old Vyshnavi (name changed), was rushed to Aster RV Hospital due to persistent right-sided seizures of arms and legs which lasted for nearly 6 hours with fever. Her family members including her parents were positive for SARS CoV-2 and recovered well 3 weeks prior to the current presentation, although the baby herself had a mild cough and cold, and was not tested for the virus. The child had undergone a first-line of treatment at a different hospital but as her condition was quickly deteriorating, she was referred to Aster RV Hospital for specialized treatment.
“We quickly intubated her, put her on a mechanical ventilator, and administered 3rd line anti-epileptic drugs. She was in shock and unresponsive. 24 hrs EEG suggested persistent seizure activity on the left side of the brain and we had to control the seizures by inducing medical coma via further medications,” said Dr. Sujatha Thyagarajan, Sr. Consultant and Lead, PICU, Aster RV Hospital.
The child continued to have fever spikes and a requirement of a continuous drip of medicines to maintain her blood pressure. Upon further probing, COVID antibodies were positive, though she did not have an active COVID infection. The child’s MRI was suggestive of a specific condition called Hemiplegia Hemiconvulsion Epilepsy syndrome affecting the left side of the brain. The child was treated with medicines such as Intravenous immunoglobulins drip, steroids, and Anakinra which help in modifying the way the body fights any infection. She showed significant improvement than on and came off the ventilator. Initially, she could not have head control and had significant weakness and fewer movements on the right side of the body/hemiplegia which is partial paralysis of the right half of the body.
“The child underwent rehabilitation and in the course of 6 weeks, made significant improvement in the general condition, body posture, and muscle tone. It is expected that the weakness will improve very slowly and steadily. “MIS-C is the most common post-Covid complication among kids and it can manifest in a number of ways. In Vyshnavi’s case, it had turned severe which led to multiple complications,” said Dr. Sujatha.
While expressing their happiness, Vyshnavi’s parents said “It was a difficult situation for us when we saw our child suffering. She could not breathe properly and was having continuous seizures. We were scared looking at her condition. Doctors at the hospital assured us about her safety and we are happy that our daughter is doing well now.”
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