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Transient unilateral oculomotor palsy and severe headache in childhood Kawasaki disease

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Abstract

Transient affliction of the cranial nerves may at times be either the presenting feature or complication of otherwise uncomplicated Kawasaki disease (KD) in infants and children. The present report describes a 6 year 9 month old boy with classical KD who developed right-sided oculomotor nerve palsy (manifested by ipsilateral ptosis and medial rectus palsy) resulting in symptoms like severe nausea, intense frontal headache and double vision. The palsy resolved within 5 days of intravenous immunoglobulin therapy, with no residual ophthalmological abnormality at 6 weeks. Besides increased intracranial pressure, which commonly occurs during the course of KD in children, secondary to aseptic meningitis, intense headache in such children may have cranial nerve paresis as accentuating factors.

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References

  1. Sundel RP, Petty RE (2005) Kawasaki disease. In: Cassidy JT, Petty RE, Laxer RM, Lindsley CB (eds) Textbook of pediatric rheumatology, 5th edn. Elsevier Saunders, Philadelphia, pp 521–538

    Google Scholar 

  2. Sundel RP, Cleveland SS, Beiser AS et al (1992) Audiologic profiles of children with Kawasaki disease. Am J Otol 13:512–515

    CAS  PubMed  Google Scholar 

  3. Poon LK, Lun KS, Ng YM (2000) Facial nerve palsy and Kawasaki disease. Hong Kong Med J 6:224–226

    CAS  PubMed  Google Scholar 

  4. Wurzburger BJ, Avner JR (1999) Lateral rectus palsy in Kawasaki disease. Pediatr Infect Dis J 18:1029–1031

    Article  CAS  PubMed  Google Scholar 

  5. Ghosh A, Chakrabartty S, Niyogi P, Bhattacharyya A (2000) Kawasaki disease with palatal palsy. Indian Pediatr 37:1266–1268

    CAS  PubMed  Google Scholar 

  6. Bushara K, Wilson A, Rust RS (1997) Facial palsy in Kawasaki syndrome. Pediatr Neurol 17:362–364

    Article  CAS  PubMed  Google Scholar 

  7. Thapa R, Mukherjee S (2008) Transient bilateral oculomotor palsy in pseudotumor cerebri. J Child Neurol 23:580–581

    Article  PubMed  Google Scholar 

  8. Ohno S, Miyajima T, Higuchi M et al (1982) Ocular manifestations of Kawasaki’s disease (mucocutaneous lymph node syndrome). Am J Ophthalmol 93:713–717

    CAS  PubMed  Google Scholar 

  9. Anand S, Yang YC (2004) Optic disc changes in Kawasaki disease. J Pediatr Ophthalmol Strabismus 41:177–179

    CAS  PubMed  Google Scholar 

  10. Felz MW, Patni A, Brooks Tesser RA (1998) Periorbital vasculitis complicating Kawasaki syndrome in an infant. Pediatrics 101:e9

    Article  CAS  PubMed  Google Scholar 

  11. Offret H (1993) Disciform keratitis and Kawasaki’s disease. J Fr Ophthalmol 16:114–116

    CAS  Google Scholar 

  12. Leonard EG, Berenson F, Wojtowicz JA, Takacs SM, Smith PG, Hostoffer RW (1997) Pseudotumor cerebri associated with Kawasaki disease. J Clin Rheumatol 3:310

    Article  CAS  PubMed  Google Scholar 

  13. International Classification of Headache Disorders (2004) Headache classification subcommittee of the international headache society, 2nd edn. Cephalalgia 24(suppl 1):1–160

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Correspondence to Rajoo Thapa.

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Thapa, R., Mallick, D., Biswas, B. et al. Transient unilateral oculomotor palsy and severe headache in childhood Kawasaki disease. Rheumatol Int 31, 97–99 (2011). https://doi.org/10.1007/s00296-009-1154-6

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  • DOI: https://doi.org/10.1007/s00296-009-1154-6

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