Among the many problems confronting the physician are those of the differential diagnosis and treatment of acute transitory cerebral manifestations in infants and in children.
The cases usually occur during the autumn and winter, and often at night. They rank next to croup in the frequency with which they disturb the sleep of the practicing physician and of the hospital intern. The patient, an infant or an older child, becomes ill suddenly, with fever, apathy or convulsions. On examination the child is drowsy or comatose, his neck is usually rigid, and the Brudzinski and Kernig signs are positive. There may even be a facial paralysis, hemiplegia or diplegia. The chest may have an occasional râle; the throat may be red, and the ear drums congested. The physical examination may, however, give negative results except for the cerebral manifestations.
It is true that the diagnosis often establishes itself within a day
LEVINSON A. ACUTE TRANSITORY CEREBRAL MANIFESTATIONS IN INFANTS AND IN CHILDREN. JAMA. 1933;101(10):765–770. doi:10.1001/jama.1933.02740350023007