Twenty-seven children, ages 6 months - 13 years, with encephalopathy complicating hemolytic-uremic syndrome are reported from The University of British Columbia, Vancouver, Canada. Seventeen had seizures and 2 died. An increased risk for developing a neurological manifestation was correlated with the female sex, the prolonged use of an antimotility agent (e.g. codeine, anticholinergic drugs) and an increased hemoglobin. 
COMMENT. These authors have previously found an association between the prolonged use of antimotility drugs and the likelihood for progression of E coli enteritis to hemolytic-uremic syndrome. Systemically absorbed verotoxins are thought to be responsible for the multiple organ involvement. A food reservoir and improper handling are the most likely vehicles for transmission of the E coli.