INTRODUCTION: Devic optic neuromyelitis is a rare clinical disease that involves severe transverse myelitis and unilateral or bilateral optic neuropathy. Its pathogenesis would be explained by demyelinization triggered by bacterial or viral infections phenomena. According to several author, prognosis would be better in children. CASE REPORT: We report a case of optic neuromyelitis in an 8-year-old child with an uneventful history who was admitted because he suffered from flaccid tetraplegia and sudden decline of the visual acuity. The ophthalmologic examination revealed bilateral neuropapillitis. The medullary MRI visualized a spreading myelitis with bifocal arachnoiditis. Search for a precipitating infectious factor showed positive IgM for viral hepatitis A. With corticosteroid treatment the child achieved total recovery of vision and recovered motor and sensorial function of the upper limbs and the trunk. Paraplegia with sphincteral disorders persisted. CONCLUSION: This case characterized by the precipitating factor (hepatitis virus A), illustrates this rare syndrome. We present a general review of the pediatric cases reported in the literature.
INTRODUCTION: Devic optic neuromyelitis is a rare clinical disease that involves severe transverse myelitis and unilateral or bilateral optic neuropathy. Its pathogenesis would be explained by demyelinization triggered by bacterial or viral infections phenomena. According to several author, prognosis would be better in children. CASE REPORT: We report a case of optic neuromyelitis in an 8-year-old child with an uneventful history who was admitted because he suffered from flaccid tetraplegia and sudden decline of the visual acuity. The ophthalmologic examination revealed bilateral neuropapillitis. The medullary MRI visualized a spreading myelitis with bifocal arachnoiditis. Search for a precipitating infectious factor showed positive IgM for viral hepatitis A. With corticosteroid treatment the child achieved total recovery of vision and recovered motor and sensorial function of the upper limbs and the trunk. Paraplegia with sphincteral disorders persisted. CONCLUSION: This case characterized by the precipitating factor (hepatitis virus A), illustrates this rare syndrome. We present a general review of the pediatric cases reported in the literature.
Authors: Andreas Gebhardt; Robert Buehler; Roland Wiest; Friedemann Tewald; Johann Sellner; Sebastian Humpert; Heinrich P Mattle; Alain Kaelin-Lang Journal: J Neurol Date: 2008-06-23 Impact factor: 4.849