Pediatr. praxi. 2025;26(1):57-60 | DOI: 10.36290/ped.2025.012

A rare cause of qualitative disorder of consciousness in an 18-year-old boy

MUDr. Markéta Ručková¹, MUDr. Petra Matalová, Ph.D.², MUDr. Alice Nogolová, Ph.D.¹

¹ Dětské lékařství, Městská nemocnice Ostrava

² Ústav farmakologie LF UP a FN Olomouc

An 18-year-old boy with epilepsy and multifocal motor neuropathy after influenza vaccination was admitted for respiratory infection and after an epileptic seizure. On admission, clinical findings were poor except for peripheral paraparesis as residual multifocal neuropathy and pharyngitis, with thrombopenia and elevation of inflammatory markers in the admission laboratory. Within 36 hours, he developed a qualitative disruption of consciousness in the nature of delirium with hallucinations, delusions, memory impairment, marked motor restlessness, and sleep inversion. The boy was subsequently transferred to the intensive care unit. Toxicological and neurological examination with lumbar puncture, MRI and CT of the brain were performed, all with negative findings, and psychiatric examination concluded organic delirium. The boy was still delirious despite high doses of midazolam, chlorpromazine and risperidone. Only after repeated interviews did the boy admit to alcohol abuse, especially absinthe, as confirmed by a high CDT level. After the administration of clomethiazole, the symptoms of delirium quickly subsided.

Keywords: delirium tremens, abuse, paediatrics, qualitative impairment of consciousness, carbohydrate-deficient transferrin (CDT).

Accepted: March 6, 2025; Published: March 19, 2025  Show citation