Introduction
Global cerebellar infarct is a relatively uncommon type of ischemic
stroke, representing about 2% of all cases. It can present with a wide
range of symptoms, including vertigo, headache, vomiting, gait
imbalance, and dysarthria. [1] Cerebellar infarction, although rare,
can also present with seizures in neonates. It has been documented that
such infarctions can occur due to various factors, including traumatic
birth and vascular insults, leading to neurological deficits and
seizures [2]. Status epilepticus is a neurological emergency
characterized by prolonged or repetitive seizures lasting over 5 minutes
without recovery of consciousness between episodes. It can be convulsive
or non-convulsive, with the latter often requiring electroencephalogram
monitoring for detection [3]. Common causes include cerebrovascular
disorders, brain trauma, infections, and low antiepileptic drug levels
in epileptic patients. Noncompliance with anticonvulsant regimens is the
most frequent cause, accounting for 28% of all cases. Less common
causes, such as inflammatory disorders and inborn errors of metabolism,
have been identified through systematic review [4]. Cerebellar
lesions, though rare, can also manifest solely as seizures in children,
potentially indicating subcortical epilepsy as status epilepticus
[5].
This report describes a 3-month-old male infant who presented with
status epilepticus and was ultimately diagnosed with cerebellar
infarction. The case highlights the diagnostic challenges in infants
with seizures, the utility of neuroimaging in identifying structural
etiologies, and the importance of a detailed clinical history and family
background in guiding investigations and management.