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RT Journal Article
SR Electronic
T1 Dextromethorphan Associated Neurotoxicity with Cerebellar Edema (DANCE) Syndrome in Young Children: Neuroimaging Features
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP ajnr.A8455
DO 10.3174/ajnr.A8455
A1 Sharma, Smily
A1 Tiwari, Sarbesh
A1 Saini, Lokesh
A1 Yadav, Taruna
A1 Manjunathan, Sujatha
A1 Panda, Ananya
A1 Choudhary, Bharat
A1 Khera, Daisy
YR 2024
UL http://www.ajnr.org/content/early/2024/08/16/ajnr.A8455.abstract
AB Dextromethorphan toxicity in young children (especially those with age 4 years or younger) can have an extremely poor prognosis if untreated. However, if timely recognized and optimally managed, it can have a good clinical outcome despite significant initial insult. We present 3 pediatric cases (< 5 years old) with sudden unresponsiveness following ingestion of cough medications containing dextromethorphan. All these children showed cytotoxic edema in cerebellar hemispheres on MR brain, with diffusion restricting foci in supratentorial white matter in 2 patients. These features resemble the recently described acute opioid toxidrome in children, the POUNCE syndrome (Pediatric Opioid Use-associated Neurotoxicity with Cerebellar Edema). Hence, we name this entity “DANCE” (Dextromethorphan Associated Neurotoxicity with Cerebellar Edema) to increase the awareness of dextromethorphan toxicity in young children and the need to promptly recognize it to initiate optimal management.ABBREVIATIONS: POUNCE= Pediatric Opioid Use-associated Neurotoxicity with Cerebellar Edema; DANCE= Dextromethorphan Associated Neurotoxicity with Cerebellar Edema