Pediatr Emerg Med J.  2018 Jun;5(1):25-29. 10.22470/pemj.2018.00199.

Moyamoya disease in a 3-year-old boy presenting with a focal motor seizure provoked by hyperventilation

• Hwang S
• Kim JH
• Yoon HM
• Yum MS

• KMID: 2435128
• DOI: http://doi.org/10.22470/pemj.2018.00199

Abstract

A previously healthy, 3-year-old boy presented to the emergency department with an afebrile focal motor seizure. He was found crying and having a seizure 30 minutes earlier. During this seizure, he was jerking his head and right extremities. Subsequent magnetic resonance imaging showed acute infarction in the bilateral frontal lobes, chiefly in the left. After hospitalization, conventional angiography demonstrated bilateral stenosis of the distal internal carotid arteries with development of lenticulostriate collaterals, which confirmed the diagnosis of moyamoya disease. It is vital to recognize focal motor seizures and situations related to hyperventilation in children with a seizure, which imply a structural lesion and a provoked cerebral ischemia in preexisting moyamoya disease, respectively.

Keyword

Angiography; Emergencies; Hyperventilation; Ischemia; Moyamoya Disease; Seizures; Stroke; Vasoconstriction

MeSH Terms

Angiography
Brain Ischemia
Carotid Artery, Internal
Child
Child, Preschool*
Constriction, Pathologic
Crying
Diagnosis
Emergencies
Emergency Service, Hospital
Extremities
Frontal Lobe
Head
Hospitalization
Humans
Hyperventilation*
Infarction
Ischemia
Magnetic Resonance Imaging
Male*
Moyamoya Disease*
Seizures*
Stroke
Vasoconstriction