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August 1965

Severe Chickenpox Encephalopathy: Treatment With Intravenous Urea, Hypothermia, and Dexamethasone

Author Affiliations

Moses Cone Hospital, Neurologist, and University of North Carolina School of Medicine, Clinical Assistant Professor.

Am J Dis Child. 1965;110(2):137-139. doi:10.1001/archpedi.1965.02090030147005

ENCEPHALOPATHY is a rare complication of chickenpox. Estimates of its incidence vary between 0.01% and 0.1%. Most cases are mild, the mortality is low, possibly of the order of 5% of those affected, and the prognosis for complete recovery in the remainder is good.1 The present patient became so critically ill that little hope was held for her survival. Dramatic improvement followed the intravenous administration of urea, and she recovered completely after further treatment with hypothermia and dexamethasone.

Report of Case  A 6-year-old white girl developed the first lesions of chickenpox on Dec 13, 1964. Chickenpox was prevalent in the community at the time. For the first few days she was only slightly ill. At no time was aspirin or any other salicylate given. On December 16 she became excessively drowsy and was admitted to the Moses Cone Hospital. That evening she responded to painful stimuli only, and her

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