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Infective acute transverse myelopathy. Report of two cases
W H Linssen1, F J Gabreëls, R A Wevers
1Institute of Neurology, University Hospital Nijmegen, The Netherlands.
Insights
Acute transverse myelopathy in children can follow adenovirus and Borrelia Burgdorferi infections. Prompt diagnosis and penicillin treatment led to good recovery in these cases, indicating neuroborreliosis.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Acute transverse myelopathy is a rare neurological disorder affecting the spinal cord.
- Infections, including viral (adenovirus) and bacterial (Borrelia Burgdorferi), are potential triggers.
- Early diagnosis and treatment are crucial for patient outcomes.
Observation:
- Two pediatric cases of acute transverse myelopathy are presented.
- Clinical presentation, specific antibody detection, and cerebrospinal fluid analysis were used for diagnosis.
- Myelin basic protein concentration was significantly elevated, suggesting demyelination.
Findings:
- Both children experienced favorable responses to penicillin treatment, consistent with neuroborreliosis.
- Complete recovery was observed in both pediatric patients.
- Adenovirus and Borrelia Burgdorferi infections were identified as preceding causes.
Implications:
- This case series highlights the importance of considering infectious etiologies in pediatric acute transverse myelopathy.
- Neuroborreliosis should be suspected in endemic areas, even with concurrent viral infections.
- Timely antibiotic intervention can lead to excellent neurological recovery in affected children.
Abstract:
Two children with acute transverse myelopathy following adenovirus and Borrelia Burgdorferi infections are presented. The diagnosis stems from the clinical presentation, the determination of specific antibodies in serum and the favorable response to penicillin treatment in the case of neuroborreliosis. Both children made a good recovery. The cerebrospinal fluid examination showed a highly increased myelin basic protein concentration, indicating demyelination.