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International Journal of Pediatrics
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Satheesh, G., Johnson, S., Guhan, B., Ahammed, N. (2018). Maple Syrup Urine Disease Induced Grand Mal Seizures: A Case Report. International Journal of Pediatrics, 6(7), 7999-8002. doi: 10.22038/ijp.2018.31454.2782
Gautam Satheesh; Suja Johnson; Balraj Guhan; Niyas Ahammed. "Maple Syrup Urine Disease Induced Grand Mal Seizures: A Case Report". International Journal of Pediatrics, 6, 7, 2018, 7999-8002. doi: 10.22038/ijp.2018.31454.2782
Satheesh, G., Johnson, S., Guhan, B., Ahammed, N. (2018). 'Maple Syrup Urine Disease Induced Grand Mal Seizures: A Case Report', International Journal of Pediatrics, 6(7), pp. 7999-8002. doi: 10.22038/ijp.2018.31454.2782
Satheesh, G., Johnson, S., Guhan, B., Ahammed, N. Maple Syrup Urine Disease Induced Grand Mal Seizures: A Case Report. International Journal of Pediatrics, 2018; 6(7): 7999-8002. doi: 10.22038/ijp.2018.31454.2782

Maple Syrup Urine Disease Induced Grand Mal Seizures: A Case Report

Article 14, Volume 6, Issue 7 - Serial Number 55, July 2018, Page 7999-8002  XML PDF (141 K)
DOI: 10.22038/ijp.2018.31454.2782
Authors
Gautam Satheesh 1; Suja Johnson1; Balraj Guhan2; Niyas Ahammed2
1Department of Pharmacy Practice, National College of Pharmacy, Calicut, Kerala, India.
2Department of Paediatrics, KMCT Woman and Child Hospital, Calicut, Kerala, India.
Abstract
Background
Maple Syrup Urine Disease (MSUD) is a rare autosomal recessive metabolic error, characterized by Branched Chain α-Keto-acid Dehydrogenase Complex (BCKDC) deficiency. Mutations in 3 genes can lead to abnormal metabolism and accumulation of leucine, isoleucine, valine and corresponding keto-acids. MSUD affects 1 in 185,000 infants globally. Seizure is a common presentation among neonates. However, in intermediate MSUD, seizures have a delayed and insidious onset, along with developmental   
Case Report
We report a case of grand mal seizures in a patient with intermediate MSUD, presenting with multiple episodes of seizure, dystonia, spastic quadriplegia, involuntary micturition and oculogyric crisis.Seizures were managed successfully with intravenous lorazepam and other supportive measures. The patient was advised to strictly adhere to branched chain amino acid restricted diet.
Conclusion
This case report emphasizes on the importance of medication adherence and dietary restrictions to prevent permanent psychomotor damage or death.
Keywords
GTCS; Genetic; MSUD; Seizures; Quadriplegia
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