[A child with choreic movement, generalized convulsion and severe neurological deterioration responded to...

Area of Science:

• Pediatric Neurology
• Autoimmunology
• Rheumatology

Background:

• Autoimmune disorders can present with severe neurological manifestations in children.
• Antiphospholipid syndrome (APS) is characterized by autoantibodies and thrombotic events, but pediatric cases with neurological symptoms are less understood.

Observation:

• A 3-year-old girl experienced acute hemiplegia, seizures, chorea, and rapid motor decline, becoming bedridden.
• The patient exhibited a severe, progressive neurological deficit suggestive of a systemic autoimmune process.

Findings:

• Intravenous cyclophosphamide pulse therapy induced a remarkable clinical improvement.
• The child recovered significantly, with only mild dysarthria remaining by age six.
• The clinical presentation and response to treatment suggested an autoimmune pathogenesis, potentially similar to antiphospholipid syndrome.

Implications:

• Cyclophosphamide therapy may be effective in treating pediatric neurological autoimmune conditions with APS-like features.
• Early diagnosis and aggressive immunosuppressive treatment can lead to substantial recovery in affected children.
• Further research into pediatric autoimmune neurological disorders and their management is warranted.