1 - Paediatric Infectious Diseases Unit, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, E.P.E.;
2 - Neurology Paediatric Department, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, E.P.E.
- 30th Annual Meeting of the European Society for Paediatric Infectious Diseases 2012, 8-12/05/2012, Thessaloniki, Greece (Poster).
Background: Acute transverse myelitis (ATM) is a rare disease in children, characterized by a spinal cord inflammatory lesion. Infectious, autoimmune, demyelinating diseases and immunizations may be associated.
Aims and methods: We report three patients with ATM and describe the clinical, radiologic, therapeutic and evolution data and investigation results of our patients.
Results: The medium age was 3 years. Two patients had a previous viral respiratory infection. No recent immunization was reported. They had acute loss of spinal cord function with plegia of the lower limbs (2) and the upper limbs (1), muscle weakness in the lower limbs (2). Bladder disturbance (2) and bowel disturbance (1) were described. No sensory loss was reported but the patients' age precluded a confident assessment. CSF examination was abnormal in one patient. No intrathecal IgG synthesis was found; one patient displayed identical oligoclonal bands in serum and CSF (mirror pattern). MRI made the diagnosis with lesions at the cervico-thoracic spinal cord in all cases. Mycoplasma pneumonia was identified in one case and Borrelia burgdorferi in another and antibiotic therapy was given to these patients. All patient received methylprednisolone pulse therapy, and one was also treated with plasmapheresis and intravenous immune globulin. One patient had neurogenic bladder dysfunction and one had sequelae 1.5 years after the occurrence.
Conclusions: Post or parainfectious inflammation is thought to be a frequent cause of ATM. Even though, all potential etiologies should be excluded. Besides the small number of cases the lack of paediatric series makes every report of great value.
Keywords: Children, Acute transverse myelitis.