Sympathetic storms in a child with a midbrain glioma: A variant of diencephalic seizures

The authors report the unusual case of a 7-year-old child, one of the young est reported to date, who developed repeated episodes of sympathetic hypera ctivity after surgical resection of a midbrain glioma, These paroxysmal eve nts were similar to previously described diencephalic seizures. However, th ere was no evidence of epileptogenic activity on electroencephalography, an d radiologic imaging did not reveal hydrocephalus or intraparenchymal hemor rhage. In this report, clinical features are described of this patient, alo ng with the novel use of clonidine-a sympathetic blocking agent-in his trea tment, published reports are reviewed on diencephalic seizures, and steps a re recommended in the treatment of a patient who presents in this manner. T he authors believe that diencephalic seizures can present with a spectrum o f autonomic features, and treatment should be tailored with the appropriate pharmacologic blockade. (C) 1999 by Elsevier Science Inc. All rights reser ved.