A three-year-old girl came to the emergency department complaining of self-limiting hypothermia for 12 days, associated cold sweat episodes and cutaneous dryness.
They occur daily, lasting from 30 minutes to several hours, being more frequent during sleep.
They are not accompanied by tonic-clonic movements, disconnection of the environment, sphincter relaxation or post-critical period.
Also, there is no association of tiritona.
Among the episodes the patient remains asymptomatic.
The patient's history included admission at 6 months of age due to suspicion of unconfirmed seizures with transfontanellar ultrasound and normal electroencephalogram (EEG).
There was no family history of epilepsy.
A maternal uncle is affected by migraine.
Upon arrival to the emergency department, the patient presented normal physical and neurological examination, with normal parameters, except for a slight decrease in heart rate.
Hypothermia is not observed at the time of examination, although the family provides an exhaustive record of previous days, with rectal temperature values between 34 and 35 °C.
All the studies performed were normal (general analysis, gas, metabolic and endocrine study, toxic in urine, EEG, magnetic resonance [MRI], Holter and echocardiogram).
After re-history of the family, they reported that the child has had episodes of self-limiting recurrent abdominal pain for a few months, and abdominal ultrasound was added to the study, with normal results.
The suspicion of PEH and taking into account the high number of episodes, together with a family history of migraine, treatment with cyproheptadine is initiated.
However, the patient refuses to eat, despite which the episodes are self-limiting over time.
Six months after the onset, the patient is asymptomatic.
