Serial Neurologic Examination in a Child With Acute Flaccid Weakness

Area of Science:

• Neurology
• Pediatrics
• Infectious Diseases

Background:

• Acute flaccid myelitis (AFM) and acute transverse myelitis (ATM) are rare neurological conditions affecting the spinal cord.
• Both can present with sudden onset of flaccid weakness, posing diagnostic challenges, especially in infants.

Purpose of the Study:

• To describe a case presentation of an infant with symptoms suggestive of AFM or ATM.
• To highlight the diagnostic considerations and clinical presentation in pediatric cases.

Main Methods:

• Case report of a 5-month-old healthy infant.
• Clinical evaluation including neurological examination and assessment of autonomic function (urinary retention).
• Differential diagnosis considered: acute flaccid myelitis versus acute transverse myelitis.

Main Results:

• The infant presented with acute flaccid weakness, a key indicator of myelitis.
• Anisocoria (unequal pupil size) suggests possible brainstem or autonomic nervous system involvement.
• Urinary retention indicated autonomic dysfunction, common in spinal cord lesions.

Conclusions:

• Infantile presentation of myelitis requires prompt and thorough neurological and etiological investigation.
• Differentiating between AFM and ATM in infants is crucial for appropriate management and prognosis.
• Early recognition of specific signs like anisocoria and urinary retention aids in diagnosis.