Pediatric Transverse Myelitis: A Case Report

Transverse myelitis (TM) is a rare inflammatory demyelinating disorder affecting the spinal cord. Although uncommon in children, approximately 20% of cases occur in the pediatric population. Children tend to have a better prognosis than adults. The etiology of TM is broad and includes, but is not limited to, viral and bacterial infections, association with other neurological disorders, and post-vaccination events. This case report describes a 16-year-old male patient who developed acute neurological deficits and urinary retention over several days. The patient was initially evaluated in the emergency department of a county hospital and was subsequently transferred to a tertiary pediatric hospital for further management. An extensive workup, including laboratory studies and imaging, revealed findings concerning for TM. The patient's symptoms did not resolve following a course of steroids. Therefore, intravenous immunoglobulin (IVIG) was added on the recommendation of the pediatric neuroimmunology team, resulting in resolution of his symptoms. He was eventually discharged home with full recovery of function and mobility. This case highlights a neurological presentation that can mimic other disorders and requires an extensive diagnostic workup for definitive diagnosis. Awareness of TM is important for early recognition and treatment, particularly in the emergency department, given the potential for rapid progression and significant morbidity.