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Journal of Child Neurology
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Hydrogen Peroxide Neurotoxicity in Childhood: Case Report With Unique Magnetic Resonance Imaging Features

George Cannon, MD

Department of Graduate Medical Education, University of Utah School of Medicine Salt Lake City, Utah

E. Martin Caravati, MD, MPH

Department of Emergency Medicine, University of Utah School of Medicine Salt Lake City, Utah

Francis M. Filloux, MD

Departments of Pediatrics and Neurology University of Utah School of Medicine Salt Lake City, Utah, filloux{at}hsc.utah.edu

Concentrated hydrogen peroxide (H2O2) intoxication is relatively rare in children. Serious irreversible neurotoxicity generally results. The case of an 11-year-old boy who inadvertently drank a concentrated (35%) H2O2 solution is described. He exhibited signs of an acute encephalopathy with cortical visual impairment. Extensive cerebrocortical diffusion restriction with apparent gyral edema was evident at 3 days following ingestion, particularly in the parieto-occipital regions bilaterally. Spontaneous neurologic improvement quickly followed, and nearly full clinical resolution was evident 1 month later. The pattern of imaging abnormalities closely resembles that of reversible posterior leukoencephalopathy. Concentrated H2O2 neurotoxicity in children can exhibit unique patterns (a reversible posterior leukoencephalopathy) and a better than expected outcome. (J Child Neurol 2003;18:805—808).

Journal of Child Neurology, Vol. 18, No. 11, 805-808 (2003)
DOI: 10.1177/08830738030180111501
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