West syndrome associated with hypoxic brain injury caused by intoxication: a case report

Case presentation: M.S.G, 1 year old, previously healthy, suffered intoxication by acaricide (organophosphate and pyrethroid) in November 2021. Patient presented seizures, vomiting, bronchoaspiration, pneumonia, severe respiratory distress two cardiorespiratory arrests. The magnetic resonance imaging showed hemorrhagic laminar cortical necrosis slight accentuation of sulci brain fissures. He was taken to the pediatric neurology using phenobarbital baclofen. electroencephalogram (EEG) an electrographic status epilepticus, it started levetiracetam nitrazepam, once there wasn't possibility hospitalization. second EEG epileptic encephalopathy, with persistence features, multifocal epileptiform activity burst-suppression occupying more than 80% record. Although tracing not typical a hypsarrhythmia, due absence slow high-voltage activity, presence semiology compatible spasms led that evolution West Syndrome. Therefore, decided start corticosteroid (prednisone 3mg/kg/day). A new abundant tracing; no episodes were observed, nor pattern epilepticus on patient improvement infantile after treatment corticosteroids for 3 months. However, withdrawal from prednisone, seizures again.