Convulsions, hemiparesis and central retinal artery occlusion due to left atrial myxoma in child

Abstract

Multiple embolizations were the hallmark of the disease in an 8-year-old boy with a left atrial myxoma. Embolizations occurred initially in both hands and legs, later in the brain with generalized seizures and hemiparesis, and finally in the left eye with occlusion of the central retinal artery and consecutive severe visual impairment. Echocardiography demonstrated the tumour which was removed without complications.

Cerebral Embolism From Atrial Myxoma in Pediatric Patients

“…6 In all 7 of the individual pediatric case reports and in our first case, the child presented with acute right hemiparesis caused by embolic occlusion involving the anterior circulation. 3,[7][8][9][10][11][12] Our second case is distinguished by presentation with ataxia, slurred speech, and ocular dysmotility. The distribution of some of the lesions on MRI was indeed suggestive of vertebrobasilar (posterior circulation) involvement.…”

“…In addition to hemiplegia and aphasia, our first patient had retinal artery occlusion, which has been described in individuals with atrial myxoma. 9,10,16 Embolus from the heart is the most common cause of retinal artery occlusion in individuals younger than 40 years. Sickle cell anemia and antiphospholipid antibodies are causes in patients younger than 30 years.…”

Neurological manifestations of cardiac myxoma: a review of the literature and report of cases

“…Although cardiac myxoma is a relatively uncommon cause of stroke, because its neurological presentation seems to occur in younger patients and has the potential for surgical cure, its recognition is particularly important 1−7 . Until 1953, when the first atrial myxoma was surgically resected, atrial myxoma was a diagnosis made exclusively at autopsy 4 .…”

An Unusual Presentation of Left Atrial Myxoma in an Adolescent

“…There are case reports and case series on pediatric patients presenting with LA myxoma but with wide age of presentation varying from 2 years to 17 years of age [9][10][11][12][13][14][15][16]. Even lab parameters were also unusually normal in our case except for only high ESR value, whereas there are studies where laboratory abnormalities (e.g., anemia and elevations in the ESR, C-reactive protein, or globulin level) were present in 35% of cardiac myxoma cases with systemic symptoms [3].…”