Differential Diagnosis for Leukocytosis with Seizure
Single Most Likely Diagnosis
- Infection (e.g., meningitis, encephalitis, or sepsis): Leukocytosis is a common response to infection, and seizures can occur due to the infection itself or as a result of the inflammatory response affecting the brain.
Other Likely Diagnoses
- Cerebrovascular accident (stroke): While not always associated with leukocytosis, an acute stroke can cause seizures, especially if it involves areas of the brain prone to seizure activity.
- Traumatic brain injury: Head trauma can lead to both leukocytosis as part of the body's response to injury and seizures due to the direct effect of the trauma on brain tissue.
- Metabolic disorders (e.g., hyponatremia, hypoglycemia): Certain metabolic imbalances can cause both seizures and an elevation in white blood cell count as the body responds to stress.
Do Not Miss Diagnoses
- Meningitis: Although mentioned under the most likely diagnosis, it's crucial to emphasize that bacterial meningitis is a medical emergency requiring prompt treatment. Missing this diagnosis could be fatal.
- Subarachnoid hemorrhage: This condition can cause seizures and may lead to a stress-induced leukocytosis. It's a critical diagnosis to consider due to its high morbidity and mortality if not promptly treated.
- Status epilepticus: While not a cause of leukocytosis per se, status epilepticus can lead to systemic complications, including an elevated white blood cell count due to stress and potential infection. It's a life-threatening condition requiring immediate intervention.
Rare Diagnoses
- Paraneoplastic syndromes: Certain cancers can cause paraneoplastic syndromes that lead to seizures and may also result in leukocytosis due to the body's response to the tumor or associated infections.
- Autoimmune encephalitis: This is a rare condition where the immune system attacks the brain, potentially causing seizures and other neurological symptoms. Leukocytosis might be seen, especially if there's an associated infection or as part of the autoimmune response.
- Neurocysticercosis: An infection caused by the pork tapeworm that can lead to seizures and, in some cases, an elevated white blood cell count, especially if there's an inflammatory response to dying parasites.