Abstract: Objective　To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) complicated with “top of the basilar” syndrome (TOBS) in children. Method　The clinical data of MPP complicated with TOBS in a child were retrospectively analyzed, and the related literature was reviewed. Results　A 6-year-old girl developed fever and inflexible movement in unilateral limb, and serum Mycoplasma pneumoniae antibody increased gradually. Lung CT showed a large area of inflammatory consolidation. Brain magnetic resonance imaging (MRI) showed multiple cerebral infarctions. After the symptomatic treatment of anti-infection, anticoagulation, thrombolysis and intracranial pressure reduction, the girl’s condition continued to worsen and she presented with coma, cough weakness, dysphagia, facial nerve paralysis and bilateral pupillary inequality. Although the vital signs of the child were stable, she could not take care of herself and was still recovering. Conclusion　MPP is often accompanied by hypercoagulative state and autoimmune abnormalities, and the prognosis of patients combined with TOBS is poor.

Key words: Mycoplasma pneumoniae pneumonia;　top of the basilar syndrome;　child