Super-refractory Status Epilepticus with Hemophagocytic Syndrome in a Child with HIV Infection
Bibliographic record
Abstract
A 3.5-year-old boy was referred for the diagnosis and management of refractory seizures. He had been previously well but 10 days prior had an upper respiratory tract infection. Three days later, he had right-sided involuntary limb movements and facial twitching. Initially, these episodes were brief with preserved consciousness, but they gradually increased in duration with alteration in the sensorium in the form of unresponsiveness and excessive crying. He was initially treated with phenytoin, valproate and levetiracetam, but the seizures remained refractory. On examination, the child was underweight (11 kg; z-score between −2 and −3) with no meningeal signs, rash, organomegaly, lymphadenopathy, papilledema or focal neurological deficits. He continued to have seizures [continuous electroencephalogram (EEG) was not available) and unexplained episodes of intermittent tachycardia. His repeated inter-ictal EEGs showed diffuse slowing and occasional left temporal sharp waves. He was treated with ceftriaxone and acyclovir for a presumed bacterial meningitis or viral encephalitis. He sequentially required phenobarbitone, lacosamide, midazolam infusion and thiopentone infusion for seizure control. The seizures were controlled for 24 h on thiopentone infusion but recurred on tapering thiopentone (super-refractory status epilepticus). He was subsequently treated with topiramate, intravenous immunoglobulins and pulse intravenous methylprednisolone.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".