Clinical presentation of the first demyelinating event in pediatrics
DOI:
https://doi.org/10.31053/1853.0605.v80.n1.29664Keywords:
Multiple Sclerosis, Pediatrics, Acute Transverse Myelitis in Demyelinating Disease of the Central Nervous SystemAbstract
Introduction: Isolated Clinical Syndrome (ACS) refers to the first clinical event with characteristics suggestive of multiple sclerosis (MS). Clinical case: We report the case of a previously healthy 8-year-old male patient hospitalized for altered gait with suspicion of transverse myelitis. Spinal MRI was performed showing evidence of hyperintense D3-D5 lesion in T2. He receives treatment with intravenous corticosteroid therapy and with the result of oligoclonal bands in serum and CSF, a diagnosis of ACS is made. Conclusion: The objective is to describe a rare form of manifestation of demyelinating disease in pediatric age and to assess the importance of timely diagnosis and treatment.
Downloads
References
Miller DH, Chard DT, Ciccarelli O. Clinically isolated syndromes. Lancet Neurol. 2012 Feb;11(2):157-69. doi: 10.1016/S1474-4422(11)70274-5.
Casallas Vanegas A, Zuluaga Rodas MI, Reyes Guerrero MA. Síndrome clínico aislado: abordaje del primer evento desmielinizante. Acta Neurológica Colombiana. 2019 35(2) 64-73 doi:10.22379/24224022236
de Seze J, Stojkovic T, Breteau G, Lucas C, Michon-Pasturel U, Gauvrit JY, Hachulla E, Mounier-Vehier F, Pruvo JP, Leys D, Destée A, Hatron PY, Vermersch P. Acute myelopathies: Clinical, laboratory and outcome profiles in 79 cases. Brain. 2001 Aug;124(Pt 8):1509-21. doi: 10.1093/brain/124.8.1509.
Confavreux C, Vukusic S, Adeleine P. Early clinical predictors and progression of irreversible disability in multiple sclerosis: an amnesic process. Brain. 2003 Apr;126(Pt 4):770-82. doi: 10.1093/brain/awg081.
Tenembaum SN. Pediatric Multiple Sclerosis: Distinguishing Clinical and MR Imaging Features. Neuroimaging Clin N Am. 2017 May;27(2):229-250. doi: 10.1016/j.nic.2016.12.007.
Bektaş G, Özkan MU, Yıldız EP, Uzunhan TA, Sencer S, Aydınlı N, Çalışkan M, Özmen M. Clinically isolated syndrome and multiple sclerosis in children: a single center study. Turk J Pediatr. 2020;62(2):244-251. doi: 10.24953/turkjped.2020.02.010.
Iaffaldano P, Simone M, Lucisano G, Ghezzi A, Coniglio G, Brescia Morra V, Salemi G, Patti F, Lugaresi A, Izquierdo G, Bergamaschi R, Cabrera-Gomez JA, Pozzilli C, Millefiorini E, Alroughani R, Boz C, Pucci E, Zimatore GB, Sola P, Lus G, Maimone D, Avolio C, Cocco E, Sajedi SA, Costantino G, Duquette P, Shaygannejad V, Petersen T, Fernández Bolaños R, Paolicelli D, Tortorella C, Spelman T, Margari L, Amato MP, Comi G, Butzkueven H, Trojano M; Italian iMedWeb Registry and the MSBase Registry. Prognostic indicators in pediatric clinically isolated syndrome. Ann Neurol. 2017 May;81(5):729-739. doi: 10.1002/ana.24938.
Bourre B, Zéphir H, Ongagna JC, Cordonnier C, Collongues N, Debette S, Fleury MC, Outteryck O, Hannequin D, Vermersch P, de Seze J. Long-term follow-up of acute partial transverse myelitis. Arch Neurol. 2012 Mar;69(3):357-62. doi: 10.1001/archneurol.2011.949. Erratum in: Arch Neurol. 2012 Jun;69(6):789. Outerryck, Olivier [corrected to Outteryck, Olivier].
Awad A, Hemmer B, Hartung HP, Kieseier B, Bennett JL, Stuve O. Analyses of cerebrospinal fluid in the diagnosis and monitoring of multiple sclerosis. J Neuroimmunol. 2010 Feb 26;219(1-2):1-7. doi: 10.1016/j.jneuroim.2009.09.002.
Tintoré M, Rovira A, Río J, Nos C, Grivé E, Téllez N, Pelayo R, Comabella M, Sastre-Garriga J, Montalban X. Baseline MRI predicts future attacks and disability in clinically isolated syndromes. Neurology. 2006 Sep 26;67(6):968-72. doi: 10.1212/01.wnl.0000237354.10144.ec.
Zhang WY, Hou YL. Prognostic value of magnetic resonance imaging in patients with clinically isolated syndrome conversion to multiple sclerosis: a meta-analysis. Neurol India. 2013 May-Jun;61(3):231-8. doi: 10.4103/0028-3886.115058.
Masjuan J, Alvarez-Cermeño JC, García-Barragán N, Díaz-Sánchez M, Espiño M, Sádaba MC, González-Porqué P, Martínez San Millán J, Villar LM. Clinically isolated syndromes: a new oligoclonal band test accurately predicts conversion to MS. Neurology. 2006 Feb 28;66(4):576-8. doi: 10.1212/01.wnl.0000198253.35119.83.
Tintoré M, Rovira A, Río J, Tur C, Pelayo R, Nos C, Téllez N, Perkal H, Comabella M, Sastre-Garriga J, Montalban X. Do oligoclonal bands add information to MRI in first attacks of multiple sclerosis? Neurology. 2008 Mar 25;70(13 Pt 2):1079-83. doi: 10.1212/01.wnl.0000280576.73609.c6.
Comi G, Filippi M, Barkhof F, Durelli L, Edan G, Fernández O, Hartung H, Seeldrayers P, Sørensen PS, Rovaris M, Martinelli V, Hommes OR; Early Treatment of Multiple Sclerosis Study Group. Effect of early interferon treatment on conversion to definite multiple sclerosis: a randomised study. Lancet. 2001 May 19;357(9268):1576-82. doi: 10.1016/s0140-6736(00)04725-5.
Kappos L, Polman CH, Freedman MS, Edan G, Hartung HP, Miller DH, Montalban X, Barkhof F, Bauer L, Jakobs P, Pohl C, Sandbrink R. Treatment with interferon beta-1b delays conversion to clinically definite and McDonald MS in patients with clinically isolated syndromes. Neurology. 2006 Oct 10;67(7):1242-9. doi: 10.1212/01.wnl.0000237641.33768.8d.
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Universidad Nacional de Córdoba
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).
