Central nervous system complications in two cases of juvenile onset dermatomyositis

Central nervous system (CNS) complications are rarely reported in either ju venile or adult onset inflammatory myositides, such as dermatomyositis and polymyositis. We report two children, aged 4 and 10 yr respectively, with a diagnosis of juvenile dermatomyositis, both of whom subsequently developed clinical features of severe CNS involvement. possibly consistent with cere bral vasculopathy. One child died from apparent brainstem involvement; the other developed seizures, pseudoseizures and clinical depression which resp onded to aggressive immunosuppression. Although the vasculopathy or vasculi tis underlying this disorder is known to have a systemic distribution, CNS involvement has rarely been reported and may be under-recognized.