Abstract
We experienced a case of involuntary movement following resuscitation from cardiopulmonary arrest (CPA) due to near-drowning. A 14-year-old boy suddenly lost consciousness to fall into the sea when he prepared angling at a harbor. The boy was underwater for about 15 minutes and was in CPA when rescued. The rescue crew immediately started cardiopulmonary resuscitation (CPR), and the boy was brought to our hospital. He was in CPA and his body temperature was as low as 32.9 degrees C. upon arrival, but uninterrupted resuscitation and warming effort recovered spontaneous circulation. The presence of cafe-au-lait spots on the trunk and his family history led us to diagnose him as neurofibromatosis typel (NF 1). Hypothermia therapy was started at 34.0 degrees C. for three days and was followed by warming to 36.5 degrees C. for two days. Intense generalized involuntary movements were observed during the rewarming period. We could not make the etiology of these movements clear whether NF1 or Lance-Adams syndrome (LAS), but could control these movements with various antiepileptic drugs. The patient regained consciousness after 17 days of treatment and was transferred to the pediatric ward on the 27th hospital day. He has now recovered to talk with others naturally and to ride a wheelchair.
