PT  - JOURNAL ARTICLE
AU  - Sharma, Smily
AU  - Tiwari, Sarbesh
AU  - Saini, Lokesh
AU  - Yadav, Taruna
AU  - Manjunathan, Sujatha
AU  - Panda, Ananya
AU  - Choudhary, Bharat
AU  - Khera, Daisy
TI  - Dextromethorphan-Associated Neurotoxicity with Cerebellar Edema Syndrome in Young Children: Neuroimaging Features
AID  - 10.3174/ajnr.A8455
DP  - 2025 Feb 01
TA  - American Journal of Neuroradiology
PG  - 390--394
VI  - 46
IP  - 2
4099  - http://www.ajnr.org/content/46/2/390.short
4100  - http://www.ajnr.org/content/46/2/390.full
SO  - Am. J. Neuroradiol.2025 Feb 01; 46
AB  - SUMMARY: Dextromethorphan toxicity in young children (especially those 4 years of age or younger) can have an extremely poor prognosis if untreated. However, if timely recognized and optimally managed, it can have a good clinical outcome despite a profound initial insult. We present 3 pediatric cases (younger than 5 years of age) with sudden unresponsiveness following ingestion of cough medications containing dextromethorphan. All these children showed cytotoxic edema in the cerebellar hemispheres on MR of the brain, with diffusion-restricting foci in the supratentorial white matter in 2 patients. These features resemble the recently described acute opioid toxidrome in children, pediatric opioid use–associated neurotoxicity with cerebellar edema (POUNCE). Hence, we named this entity dextromethorphan-associated neurotoxicity with cerebellar edema (DANCE) to increase the awareness of dextromethorphan toxicity in young children and the need to promptly recognize it to initiate optimal management.DANCEdextromethorphan-associated neurotoxicity with cerebellar edemaIgGimmunoglobulin GPOUNCEpediatric opioid use–associated neurotoxicity with cerebellar edema