A Treatable Cause of Cerebral Palsy: Brain Abscess Masquerading as Cerebral Palsy

ABSTRACT

Introduction

A brain abscess is an intraparenchymal collection of pus in the brain. Cerebral palsy (CP) is a static encephalopathy due to injury to the developing brain. CP is a group of disorders due to multiple etiologies. We are reporting a rare cause of brain abscess presenting as CP.

Case description

A 12-month-old boy presented with a developmental delay with perinatal depression. He had attained only partial head control. On examination, head size was 42.5 cm between –2SD and –3SD, and tone was increased in both spasticity and dystonia with exaggerated deep tendon reflexes. On investigations, complete blood count, liver function test, and renal function test were normal. Magnetic resonance imaging (MRI) of the brain showed two ring-enhancing lesions in the left frontal and right temporoparietal lobe. The cerebrospinal fluid (CSF) showed two lymphocytes, protein of 32 mg/dL, and glucose of 60.1 mg/dL. Due to nonreduction in size of the abscess on repeat MRI of the brain after 4 weeks of intravenous antibiotics, the child underwent burr hole aspiration of abscess in the left frontal lobe. The intravenous antibiotics continued for another 4 weeks. On follow-up, computed tomography (CT) of the brain showed a reduction in the size of brain abscesses with calcification. The child attained a social smile, reached for objects, and his tone was improved.

Conclusion

For any child presenting with developmental delay with perinatal history of hypoxic–ischemic encephalopathy (HIE), neuroimaging should be done as it gives important clues for etiology and helps in specific management and prognosis.

How to cite this article

Gowda VK, Mohanty SB, Dhananjaya KVN. A Treatable Cause of Cerebral Palsy: Brain Abscess Masquerading as Cerebral Palsy. Pediatr Inf Dis 2023;5(2):52-55.