The patient is a 9-year old boy, native of and resident in Parsabad Moghan who was hospitalized in this Center on June 24,2005 due to dizziness, feebleness and vomiting. The problem started on May 12,2005 when he fainted and went dizzy on his way to school. Consequently, he started vomiting and was taken to Parsabad Hospital. In the hospital, he had repeated convulsions accompanied by fever. The convulsions were GTC type gradually changing into status epilepticus. As his convulsions could not be controlled and his conditions aggravated, the Patient was transferred to Ardebil Hospital.

PMH: Seizure History:  The Patient had a history of seizure in the form of GTC and Staring since 2 years ago and had gone under treatment with Phenobarbital of 100mg/ daily dosage. He had later become D/C but his convulsions continued until the time of hospitalization.

Parents are far relatives and have two other healthy children.

In Ardebil, admitted with clinical manifestation of headache, neck rodor, reduced consciousness level and repeated convulsions and LP was carried out and reported as:

RBC = 600

WBC = 10

Prot = 165

glu = 26

Brain CT was taken and reported non-communicated hydrocephaly.

His disease was diagnosed as encephalitis 24 hours after hospitalization in Ardebil, the convulsions was controlled with Phenobarbital. but the patient is then afflicted to Lt.  hemiplegia .

Four days after discharge from the hospital, the patient is again afflicted with attacks of vomiting, headache and dizziness and is referred to this Center (Mofid Hospital). Upon entry to the Hospital, the patient was ill and febrile and in a state of dizziness, feebleness and headache. He was unable to stand or walk and had recurrent vomiting.

On examination: Hc= 52  Wt: 18    fundoscopy NL DTR +++, Plantar Reflexdown and Lt. hemiparesis. Once again, LP was done for the patient, PCR Herpes Virus and CFS study in view of tb along with Gastric Washing in view of BK was requested. Based on the results of LP:

Glucose = 10     

Prot. = 650                         

RBC = 3                

WBC = 256 →P %10, L90%

CSF CULTURE = Neg

PCR HERPES: Neg

CBC: WBC = 5700

( POLY = 68 LYM = 29 )

Hb = 11 MCV = 77    PLT = 210000              

K=4/3        Mg=3                Na=141

SGOT=22      SGPT =31

  Bil=0/8                        

CRP=+  ESR=16-12          

BS = 108                  

 FBs=96     Ca=8/5     P=4/5

U/A U/C=NL

 What is the patient's possible diagnosis?