Journal article
Dextromethorphan Associated Neurotoxicity with Cerebellar Edema (DANCE) Syndrome in Young Children: Neuroimaging Features
American journal of neuroradiology : AJNR, Vol.46(2), pp.390-394
02/2025
DOI: 10.3174/ajnr.A8455
PMCID: PMC11878978
PMID: 39151957
Abstract
Dextromethorphan toxicity in young children (especially those with age 4 years 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 significant initial insult. We present 3 pediatric cases (< 5 years old) with sudden unresponsiveness following ingestion of cough medications containing dextromethorphan. All these children showed cytotoxic edema in cerebellar hemispheres on MR brain, with diffusion restricting foci in supratentorial white matter in 2 patients. These features resemble the recently described acute opioid toxidrome in children, the POUNCE syndrome (Pediatric Opioid Use-associated Neurotoxicity with Cerebellar Edema). Hence, we name this entity "DANCE" (Dextromethorphan Associated Neurotoxicity with Cerebellar Edema) to increase the awareness of dextromethorphan toxicity in young children and the need to promptly recognize it to initiate optimal management.ABBREVIATIONS: POUNCE= Pediatric Opioid Use-associated Neurotoxicity with Cerebellar Edema; DANCE= Dextromethorphan Associated Neurotoxicity with Cerebellar Edema.Dextromethorphan toxicity in young children (especially those with age 4 years 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 significant initial insult. We present 3 pediatric cases (< 5 years old) with sudden unresponsiveness following ingestion of cough medications containing dextromethorphan. All these children showed cytotoxic edema in cerebellar hemispheres on MR brain, with diffusion restricting foci in supratentorial white matter in 2 patients. These features resemble the recently described acute opioid toxidrome in children, the POUNCE syndrome (Pediatric Opioid Use-associated Neurotoxicity with Cerebellar Edema). Hence, we name this entity "DANCE" (Dextromethorphan Associated Neurotoxicity with Cerebellar Edema) to increase the awareness of dextromethorphan toxicity in young children and the need to promptly recognize it to initiate optimal management.ABBREVIATIONS: POUNCE= Pediatric Opioid Use-associated Neurotoxicity with Cerebellar Edema; DANCE= Dextromethorphan Associated Neurotoxicity with Cerebellar Edema.
Details
- Title: Subtitle
- Dextromethorphan Associated Neurotoxicity with Cerebellar Edema (DANCE) Syndrome in Young Children: Neuroimaging Features
- Creators
- Smily Sharma - All India Institute of Medical Sciences JodhpurSarbesh Tiwari - All India Institute of Medical Sciences JodhpurLokesh Saini - All India Institute of Medical Sciences JodhpurTaruna Yadav - All India Institute of Medical Sciences JodhpurSujatha Manjunathan - All India Institute of Medical Sciences JodhpurAnanya Panda - All India Institute of Medical Sciences JodhpurBharat Choudhary - All India Institute of Medical Sciences JodhpurDaisy Khera
- Resource Type
- Journal article
- Publication Details
- American journal of neuroradiology : AJNR, Vol.46(2), pp.390-394
- DOI
- 10.3174/ajnr.A8455
- PMID
- 39151957
- PMCID
- PMC11878978
- NLM abbreviation
- AJNR Am J Neuroradiol
- ISSN
- 1936-959X
- eISSN
- 1936-959X
- Publisher
- AMER SOC NEURORADIOLOGY
- Language
- English
- Electronic publication date
- 08/16/2024
- Date published
- 02/2025
- Academic Unit
- Radiology
- Record Identifier
- 9984700439002771
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