Sir.—Convulsions are very rare in the early stages of viral hepatitis. To our knowledge, only four cases have been reported in adults. We present two cases of children who suffered from hepatitis A virus infection with concomitant convulsions.
Patient Reports.—Patient 1.—An 8-year-old girl was admitted because of generalized convulsive seizure. Eight days prior to admission she started suffering from loss of appetite and vomiting. Two days before hospitalization urinalysis revealed bilirubin. On the day of admission she underwent a first episode of a tonoclonic symmetrical convulsive seizure in all four limbs with rolling of the eyes that lasted 5 minutes. There was no fever at that time, nor was there any history of central nervous system trauma or drug usage. No family history of convulsive disorder could be elicited. On examination, she was slightly jaundiced, and the abdomen was soft, with a mildly tender liver palpated 4