Epilepsy due to a destructive brain lesion caused by a scorpion sting.

BACKGROUND Symptomatic acute epileptic seizures may occur in up to 5% of individuals, especially children, with scorpion stings. The occurrence of a long-lasting brain lesion or the development of epilepsy after a scorpion sting has never been observed. OBJECTIVE To describe the development of epilepsy secondary to an extensive hemispheric destructive brain lesion after a scorpion sting. PATIENT A 15-year-old with a moderate global cognitive impairment and a mild left hemiparesis, with seizures occurring approximately once monthly. RESULTS The mother reported that the patient at the age of 4 years was stung by a brown scorpion, Tityus serrulatus. The patient soon developed local pain and paresthesias followed by diaphoresis and somnolence. Approximately 24 hours after the sting, she began to convulse. She was then taken to a hospital where she achieved suboptimal seizure control, with daily tonic-clonic seizures and left hemiplegia during the following week. During our clinical investigation, her routine electroencephalogram showed the presence of interictal spikes and diffuse slowing in the right brain hemisphere. Magnetic resonance imaging showed a widespread destructive lesion of her right cerebral hemisphere affecting both the cortical and subcortical structures. CONCLUSION This is a rare illustration of the biological effects of the toxin of T serrulatus concerning its excitotoxicity and the potential to induce a brain lesion of an epileptogenic nature.