PEDIATRICS Vol. 75 No. 4 April 1985, pp. 687-692
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Neurologic Manifestations of Schoenlein-Henoch Purpura: Report of Three Cases and Review of the Literature

Anita Lesgold Belman MD1, Carol R. Leicher MD1, Solomon L. Moshé MD1, and Andrew P. Mezey MD1

1 From the Departments of Neurology and Pediatrics, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, and Departments of Pediatrics and Neurology, University of Connecticut, Farmington

Three patients developed prominent neurologic symptoms and signs associated with Schoenlein-Henoch purpura. A 71/2-year-old boy was seen with status epilepticus after a 2-week history of generalized headaches, irritability, and intermittent colicky abdominal pain. A left hemiparesis and a left homonymous hemianopia with a right gaze preference that were present on initial examinations gradually resolved, but a mild left arm paresis persisted. Cutaneous, renal, and joint involvement followed initial CNS manifestations. The second patient, a 7-year-old girl, had a complex partial seizure with secondary generalization and a postictal hemiparesis seven days after presentation with classic signs of Schoenlein-Henoch purpura. Behavioral changes were noted during the acute phase of the illness. The third patient, a 13-year-old boy, developed signs of a left brachial plexopathy and transient weakness of his right leg during a complicated course of Schoenlein-Henoch purpura. Review of the world literature indicates that headaches and mental status changes are the most frequent neurologic complications of Schoenlein-Henoch purpura, followed by seizures, focal neurologic deficits, mononeuropathies, and polyradiculoneuropathies. The vasculitis of Schoenlein-Henoch purpura can involve the nervous system and may add significantly to the morbidity of the illness.

Key Words: Schoenlein-Henoch purpura • Henoch-Schoenlein purpura • encephalopathy • seizures • cerebrovascular accidents • neuropathy

Submitted on February 3, 1984
Accepted on April 20, 1984


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