A case of acute disseminated encephalomyelitis presented with transvers myelitis Case Report

Abstract

Summary Acute disseminated encephalomyelitis is an inflammatory and demyelinating disorder of central nervous system A 9 year old male was admitted with unable to walk non sensation of legs urinary incontinence and encopresis for 2 days On physical examination muscle strength was 5 5 on upper extremities and 1 5 on lower extremities Loss of pain temperature and touch sensation was present on both lower extremities reaches to T8 level On spinal magnetic resonance imaging diffuse hyperintensity from C3 to conus medullaris was detected While electromyography was consistent with polyradiculoneuritis magnetic resonance imaging findings were concordant with acute disseminated encephalomyelitis On account of this case we would like to emphasize that acute disseminated encephalomyelitis should be considered in patients presented with transverse myelitis; therefore in addition to spinal magnetic resonance imaging cranial magnetic resonance imaging should be examined in these patients Turk Arch Ped 2010; 45: 299 302 Key words: Acute disseminated encephalomyelitis child transverse myelitis

Keywords

• -

Transvers miyelit tablosu ile getirilen akut dissemine ansefalomiyelit olgusu – Olgu Sunumu

Öz

Özet Akut dissemine ansefalomiyelit merkezi sinir sisteminin enflamatuvar demiyelinizan bir hastalığıdır Dokuz yaşında erkek hasta iki gün önce başlayan yürüyememe bacaklarını hissedememe idrar ve dışkı kaçırma yakınması ile getirildi Fizik bakısında üst ekstremitelerde kas gücü 5 5 alt ekstemitelerde 1 5 idi Her iki alt ekstremitelerden başlayıp T8 düzeyine kadar uzanan yüzeyel duyu kaybı vardı Spinal manyetik rezonans görüntülemesinde C3 rsquo;ten konus medüllarise uzanan ve kontrast madde tutulumu gösteren hiperintens yaygın lezyon saptandı Elektromiyografi poliradikülonevritle beyin manyetik rezonans görüntülemesi bulguları akut dissemine ansefalomiyelit ile uyumluydu Bu olgu dolayısıyla transvers miyelit tablosu ile getirilen hastalarda akut dissemine ansefalomiyelit olabileceğini bu nedenle spinal manyetik rezonans görüntülemesi yanında kraniyal manyetik rezonans görüntülemesinin de yapılmasının uygun olacağını vurgulamak isteriz Türk Ped Arş 2010; 45: 299 302 Anahtar sözcükler: Akut dissemine ansefalomiyelit çocuk transvers miyelit

Anahtar Kelimeler

• Akut dissemine ansefalomiyelit, çocuk, transvers miyelit

Kaynakça

1. Rosman NP, Gottlieb SM, Bernstein CA. Acute hemorrhagic leukoencephalitis: recovery and reversal of magnetic reso- nance imaging findings in a child. J Child Neurol 1997; 12: 448-54. (Abstract) / (PDF)
2. Johnston MV. Demyelinating disorders of the central nervous system. In: RM Kliegman, RE Behrman. HB Jenson, BF Stanton (eds). Nelson Textbook of Pediatrics 18 th edition. Philadelphia: WB Saunders, 2007; 2505-7.
3. Leake AD, Albani S, Kao SA, et al. Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features. Pediatr Infect Dis J 2004; 23: 756–64. (Abstract)
4. Stonehouse B, Gupte G, Wassmer E, Whitehouse WP. Acute disseminated encephalomyelitis: recognition in the hands of general paediatricians. Arch Dis Child 2003; 88: 122- 4. (Abstract) / (Full Text) / (PDF)
5. Yeh EA, Collins A, Cohen ME, Duffner PK, Faden H. Detection of coronavirus in the central nervous system of a child with acute disseminated encephalomyelitis. Pediatrics 2004; 113: 73-6. (Abstract) / (Full Text) / (PDF)
6. Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean MJ. Clinical and neuroradiologic features of acute dis- seminated encephalomyelitis in children. Neurology 2001; 56: 1308-12. (Abstract) / (Full Text) / (PDF)
7. Rajesh B, Preeti S, Vishali M, Mamta V. Acute disseminated encephalomyelitis. Indian J Pediatr 2004; 71: 1035-8.
8. Alper G, Schor NF. Toward definition of acute disseminated encephalitis of childhood. Curr Opin Pediatr 2004; 16: 637-40. (Abstract)

9. Andreula CF, Angelo NM, Recchia L, Milella D. MRI in the diagnosis of acute disseminated encephalomyelitis. Int J Neuroradiol 1997; 3: 21-34.
10. Lidia V, Gabis MD, Panasci DJ, Andriola MR, Huang W. Acute disseminated encephalomyelitis: an MRI/MRS longitudinal study. Pediatr Neurol 2004; 30: 324-9. (Abstract) / (Full Text) / (PDF)
11. Kabakuş N, Çıtak NA, Kurt A. Akut dissemine ensefalomyelit: klinik seri. Fırat Tıp Dergisi 2005;10: 127-31. (Abstract) / (Full Text) / (PDF)
12. Murthy SN, Faden HS, Cohen ME, Bakshi R. Acute dissemi- nated encephalomyelitis. Pediatrics 2002; 110: e21.