Two thyrotoxic children, ages 10 and 11 years, who presented with seizures and coma are reported from the Departments of Pediatrics, Bolzano Hospital and the University of Pavia, Italy. Patient 1 was admitted with vomiting, headache, and stupor. He had dilated pupils, nuchal rigidity, and tachycardia. A goiter was palpable. A generalized seizure lasting 20 min was repeated despite diazepam intravenously. Serum thyroid hormone levels were markedly elevated. Patient 2 had a thyrotoxic crisis complicated by status epilepticus and coma. Both patients had abnormal EEGs, with slow activity in temporal regions and high voltage fast activity in frontal areas. [1]

COMMENT. The authors cite only one other child with these symptoms reported in the literature, and 10 adult cases. Patients with seizures and coma of undetermined cause should be tested for hyperthyroidism.