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January 31, 1977

Viral Hepatitis Type B Presenting With Seizure

JAMA. 1977;237(5):472-473. doi:10.1001/jama.1977.03270320050023

NEUROLOGICAL signs and symptoms may rarely herald the onset of infectious hepatitis.1,2 Seizures as a presenting sign are exceedingly rare. Four cases of convulsions preceding or coincident with the onset of the icteric phase of infectious hepatitis have been documented,3,4 and one case of status epilepticus has recently been reported.4 None of these cases were shown to be associated with hepatitis type B surface antigen(HBsAg)-positive viral hepatitis. A patient with viral hepatitis type B was recently admitted to this hospital after a generalized tonic-clonic seizure. Focal EEG changes remitted during the convalescent stage of his illness, and the patient has remained free of clinical or EEG evidence of seizures during a four-year period of observation.

Report of a Case  A 21-year-old, right-handed male construction worker was admitted to the Massachusetts General Hospital after a tonic-clonic convulsion lasting approximately two minutes unassociated with tongue-biting or incontinence.