Acute Transverse and Flaccid Myelitis in Children

Theroux, Liana; Brenton, J. Nicholas

doi:10.1007/s11940-019-0603-0

Cited by 18 publications

(17 citation statements)

References 64 publications

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“…However, about 20% of all pediatric acquired demyelinating syndrome cases are associated with ATM. The age distribution of ATM is bimodal, with children under five and those older than ten years of age making up the primary groups [1][2][3]. Studies have found that 66-85% of pediatric patients with ATM develop longitudinally extensive transverse myelitis (LETM) and present with spinal cord damages in more than three vertebral segments.…”

Section: Introductionmentioning

confidence: 99%

Mycoplasma pneumoniae Associated Acute Transverse Myelitis: An Atypical Clinical Presentation in an Adolescent Child

He¹,

Lee²,

Kahana³

2021

Cureus

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We report an atypical case of a 15-year-old pediatric patient diagnosed with Mycoplasma pneumoniae associated acute transverse myelitis (ATM). The patient had no prodromal or pulmonary symptoms that are commonly associated with mycoplasma infection. Yet, the patient exhibited acute bilateral lower extremity paralysis, paresthesia, decreased sensation at the level of T11 and below, bowel and bladder dysfunction, and thrombocytopenia. Magnetic resonance imaging of the spinal cord revealed transverse myelitis from T10 to the end of the conus medullaris. The patient showed only slow clinical improvement despite therapy consisting of azithromycin, high-dose intravenous methylprednisolone, intravenous immunoglobulin, and plasmapheresis. This report calls attention to the importance of early identification of mycoplasma as an underlying cause of ATM and the potential consequences of delayed detection and treatment: more severe neurologic complications, prolonged hospitalization, and unfavorable clinical outcomes.

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Section: Introductionmentioning

confidence: 99%

Mycoplasma pneumoniae Associated Acute Transverse Myelitis: An Atypical Clinical Presentation in an Adolescent Child

He¹,

Lee²,

Kahana³

2021

Cureus

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“…Two main types of acute myelitis exist: AFM and ATM. [ 3 ] AFM has an incidence of 14 children out of every 1,000,000 and is characterized by lesions primarily restricted to the anterior horn cells resulting in primarily motor weakness. AFM has been shown to be temporally associated with enterovirus D68 and A71, although its causality has yet to be proven.…”

Section: Discussionmentioning

confidence: 99%

Multiple extubation failures following a rhino-enteroviral infection

Annamalai

Bhalala

2021

Journal of Postgraduate Medicine

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This case report reviews the hospital course of a 15-month-old girl admitted to the PICU for acute respiratory failure due to enterovirus infection; who subsequently had multiple extubation failures secondary to acute transverse myelitis. This rare presentation highlights the importance of assessing the neurological status in a patient with rhino-enteroviral respiratory infection and of considering acute transverse myelitis as an etiology for difficulty with extubation.

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“…34,35 Acute transverse myelitis is an acute inflammatory disease of the spinal cord occurring with an estimated incidence in children of 2 per 1,000,000 cases per year and a mild predominance in males. 36 Its main clinical hallmarks include symmetric paraplegia or tetraplegia, decrease or loss of sensation, and sphincter dysfunctions under the lesion level. 36 The lack of sensory impairment may help to discriminate transverse myelitis versus infectious myelitis caused by mycoplasma, CMV, enteroviruses, HIV, West Nile virus, dengue virus, syphilis, Lyme disease, or Human T-cell lymphotropic virus type 1 (HTLV-1).…”

Section: Persistent Loss Of Consciousness: Approach In the Emergency Settingsmentioning

confidence: 99%

“…36 Its main clinical hallmarks include symmetric paraplegia or tetraplegia, decrease or loss of sensation, and sphincter dysfunctions under the lesion level. 36 The lack of sensory impairment may help to discriminate transverse myelitis versus infectious myelitis caused by mycoplasma, CMV, enteroviruses, HIV, West Nile virus, dengue virus, syphilis, Lyme disease, or Human T-cell lymphotropic virus type 1 (HTLV-1). 34,36 The association of muscle pain and lower limb weakness in patients with fever, headache, respiratory symptoms, and increase of serum creatin kinase should always suggest an infectious myositis that is mainly caused by influenza viruses, coxsackie, or mycoplasma.…”

Section: Persistent Loss Of Consciousness: Approach In the Emergency Settingsmentioning

confidence: 99%

“…36 The lack of sensory impairment may help to discriminate transverse myelitis versus infectious myelitis caused by mycoplasma, CMV, enteroviruses, HIV, West Nile virus, dengue virus, syphilis, Lyme disease, or Human T-cell lymphotropic virus type 1 (HTLV-1). 34,36 The association of muscle pain and lower limb weakness in patients with fever, headache, respiratory symptoms, and increase of serum creatin kinase should always suggest an infectious myositis that is mainly caused by influenza viruses, coxsackie, or mycoplasma. 34 Fluctuating weakness of ocular, facial, limb, bulbar, and respiratory muscles associated with an increasing fatigability may represent the initial presentation of myasthenia gravis while acute diplopia may be caused by different life-threatening conditions (including brain tumors, demyelinating conditions, idiopathic intracranial hypertension, and major posttraumatic diseases) in about one fifth of the cases.…”

Section: Persistent Loss Of Consciousness: Approach In the Emergency Settingsmentioning

confidence: 99%

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Management of Neurological Emergencies in Children: An Updated Overview

Mastrangelo

Baglioni

2021

Neuropediatrics

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Neurological emergencies account for about one-third of the highest severity codes attributed in emergency pediatric departments. About 75% of children with acute neurological symptoms presents with seizures, headache, or other paroxysmal events. Life-threatening conditions involve a minor proportion of patients (e.g., less than 15% of children with headache and less than 5% of children with febrile seizures). This review highlights updated insights about clinical features, diagnostic workup, and therapeutic management of pediatric neurological emergencies. Particularly, details will be provided about the most recent insights about headache, febrile seizures, status epilepticus, altered levels of consciousness, acute motor impairment, acute movement disorders, and functional disorders, as well as the role of diagnostic tools (e.g., neuroimaging, lumbar puncture, and electroencephalography), in the emergency setting. Moreover, the impact of the current novel coronavirus disease2019 (COVID-19) pandemic on the evaluation of pediatric neurologic emergencies will also be analyzed.

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Acute Transverse and Flaccid Myelitis in Children

Cited by 18 publications

References 64 publications

Mycoplasma pneumoniae Associated Acute Transverse Myelitis: An Atypical Clinical Presentation in an Adolescent Child

Mycoplasma pneumoniae Associated Acute Transverse Myelitis: An Atypical Clinical Presentation in an Adolescent Child

Multiple extubation failures following a rhino-enteroviral infection

Management of Neurological Emergencies in Children: An Updated Overview

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