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Hemiballismus revealing multiple sclerosis in an infant
M Giroud1, D Semama, L Pradeaux
1Service de Neurologie, Hôpital Général, Dijon, France.
Summary
This case report details a rare instance of infant multiple sclerosis (MS) presenting with hemiballismus and optic neuritis. Early diagnosis and treatment are crucial for managing pediatric MS symptoms.
Area of Science:
- Neurology
- Pediatrics
- Neuroimmunology
Background:
- Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Pediatric MS is rare, with limited case studies, especially in infants.
- Hemiballismus, a hyperkinetic movement disorder, is an uncommon initial presentation of MS.
Observation:
- A 15-month-old infant presented with acute left hemiballismus, Marcus-Gunn pupil, and retrobulbar optic neuritis.
- Symptoms resolved spontaneously within a week, followed by paraparesis and left sixth cranial nerve palsy.
- Cerebrospinal fluid analysis revealed elevated white blood cells and oligoclonal bands, indicative of central nervous system inflammation.
Findings:
- The clinical presentation and diagnostic findings strongly suggest definite multiple sclerosis in an infant.
- Hemiballismus as the initial symptom in pediatric MS is exceptionally rare.
- Abnormal evoked visual potentials further supported the diagnosis of demyelinating disease.
Implications:
- This case highlights the diverse and unusual initial presentations of multiple sclerosis in infancy.
- It underscores the importance of considering MS in infants with unexplained neurological deficits.
- Further research into early-onset MS is needed to understand its unique pathophysiology and optimize treatment strategies.