Seizures in a patient of adult onset Still′s disease

Adult onset Still′s disease (AOSD) is a rare systemic inflammatory disorder, characterized by high fever, salmon-colored rash, polyarthritis and multi-organ involvement. Yamaguchi′s criteria and high serum ferritin levels help to diagnose this disease. It is mostly a diagnosis of exclusion. AOSD involves predominantly the joints, liver and skin, but can involve any organ. Neurological involvement is relatively rare and seizures are usually due to fulminant hepatic failure, meningoencephalitis and posterior reversible encephalopathy syndrome/thrombotic thrombocytopenic purpura. Seizures which occur without these conditions and can be exclusively ascribed to the primary disease process alone have not been reported in the literature. We report a patient of AOSD who was treated with immunosuppressants and during the course of her illness presented with generalized tonic-clonic seizures which were attributable primarily to AOSD. Hence seizures per se can be an event in such patients and need to be watched for and treated