RT Journal Article
SR Electronic
T1 Dextromethorphan-Associated Neurotoxicity with Cerebellar Edema Syndrome in Young Children: Neuroimaging Features
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
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 2025
UL http://www.ajnr.org/content/early/2025/01/16/ajnr.A8455.abstract
AB Dextromethorphan toxicity in young children (especially those 4 years of age 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 a profound initial insult. We present 3 pediatric cases (younger than 5 years of age) with sudden unresponsiveness following ingestion of cough medications containing dextromethorphan. All these children showed cytotoxic edema in the cerebellar hemispheres on MR of the brain, with diffusion-restricting foci in the supratentorial white matter in 2 patients. These features resemble the recently described acute opioid toxidrome in children, pediatric opioid use–associated neurotoxicity with cerebellar edema (POUNCE). Hence, we named this entity dextromethorphan-associated neurotoxicity with cerebellar edema (DANCE) to increase the awareness of dextromethorphan toxicity in young children and the need to promptly recognize it to initiate optimal management.DANCEdextromethorphan-associated neurotoxicity with cerebellar edemaIgGimmunoglobulin GPOUNCEpediatric opioid use–associated neurotoxicity with cerebellar edema