Aster Hospital doctors save one-year-old baby from rare MIS-C manifestation

Bengaluru: In a rare post-Covid-19 complication, a one-year-old child was diagnosed with Hemiconvulsion-Hemiplagia-Epilepsy syndrome (HHES) which leads to multiple episodes of seizures and paralysis on the right side of the child's body. HHES is a very rare manifestation of multisystem inflammatory syndrome in children (MIS-C).

One-year-old Vyshnavi (name changed) was rushed to the hospital due to persistent seizures in right arm and leg lasting for nearly 6 hours along with fever. Her condition continued to get worse and was referred to Aster RV Hospital. Roughly three weeks back, the parents had recovered from Covid-19 after testing positive while the child did not test positive for the virus despite showing the symptoms. "We quickly intubated her, put her on a mechanical ventilator and administered 3rd line anti-epileptic drugs. She was in shock and unresponsive. Twenty-four hours EEG suggested persistent seizure activity on the left side of the brain and we had to control the seizures by inducing medical coma via further medications," explained Dr Sujatha Thyagarajan, Sr. Consultant and Lead, PICU, Aster RV Hospital.

As her condition continued to deteriorate, doctors conducted further tests and discovered that she was positive for Covid-19 antibodies but did not have the Covid-19 infection. MRI showcased more specific condition called Hemiplegia Hemiconvulsion Epilepsy syndrome affecting the left side of the brain. She continued to suffer from fever spikes and required a continuous drip of medications to keep her blood pressure stable.

Doctors decided to treat the child with medicines such as intravenous immunoglobulins drip, steroids and Anakinra which help in modifying the way the body fights any infection. Consequently, she responded positively to the treatment and was removed from the ventilator. Initially, she could not control her head and experienced extreme levels of weakness and lack of mobility on the right side of the body. Due to hemiplegia, the right part of her body was in partial paralysis.

After six weeks of rehabilitation, she made significant improvements in general condition, body posture and muscle tone. The recovery of such patients happens very slowly and steadily. "MIS-C is the most common post-Covid complication among kids and it can manifest in several ways. In Vyshnavi's case, it had turned severe which led to multiple complications," said Dr Sujatha.