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.