Acute disseminated encephalomyelitis: Extremely rare presentation of pediatric human immunodeficiency virus infection

Patra, Kailash Chandra; Shirolkar, Mukund Sudhir; Ghane, Vaishali Ramchandra

doi:10.4103/1817-1745.139326

Cited by 9 publications

(4 citation statements)

References 12 publications

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“…In the literature, cases with facial paralysis have rarely been reported. However, the association between facial paralysis and ADEM was not explained clearly (12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

“…Tripathy et al (14) reported a 36-year-old male with behavioral abnormalities, hemispatial neglect of left upper limb, paralysis of the left facial nerve, left arm, and right leg. Patra et al (15) reported a 10-year-old child who had left upper motor neuron facial palsy with left hemiplegia, paralyzed right lower limb, exaggerated deep tendon reflexes, and bilateral extensor plantar responses. Kaymakamzade et al (16) reported a 25-yearold male with bilateral central facial palsy and severe quadriparesis.…”

Section: Discussionmentioning

confidence: 99%

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Akut Dissemine Ensefalomiyelite Bağlı Periferik Fasiyal Sinir Felci Gelişen Bir Çocuk Hasta

Yel¹,

Yarar²,

Kaplan³

et al. 2021

Osmangazi̇ Journal of Medicine

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Acute disseminated encephalomyelitis (ADEM) is considered a monophasic acute demyelinating disorder of the central nervous system characterized by diffuse neurologic signs and symptoms coupled with evidence of multifocal lesions of demyelination on neuroimaging. The common presenting symptoms are lethargy, fever, vomiting, headache, meningeal signs, and seizures. Neurological manifestations included altered sensorium, multiple cranial nerve involvement, quadriplegia and paraplegia, dystonia and choreiform movements, ataxia, nystagmus, bladder involvement, speech defect, and double vision. Peripheral facial nerve palsy rarely accompanies. We describe the case of a 7-year-old girl who developed acute disseminated encephalomyelitis with right peripheral facial paralysis. She was admitted to the hospital with visual impairment, depressed mood, gait disturbance, and deterioration of facial expressions. She had horizontal and vertical nystagmus, right peripheral facial paralysis, ataxic gait, and hyperactive deep tendon reflexes. The cerebrospinal fluid (CSF) examination was normal. Cerebral magnetic resonance imaging (MRI) showed multiple white matter lesions. We observed a significant improvement in clinical findings with high dose methylprednisolone pulse therapy. Keywords: Acute disseminated encephalomyelitis, facial nerve palsy, child, high-dose methylprednisolone pulse therapy Özet: Akut dissemine ensefalomiyelit (ADEM), nörogörüntülemede multifokal demiyelinasyon lezyonlarının kanıtıyla birlikte yaygın nörolojik belirti ve semptomlarla karakterize, santral sinir sisteminin monofazik akut demiyelinizan bir bozukluğu olarak kabul edilir. Yaygın görülen semptomlar letarji, ateş, kusma, baş ağrısı, meningeal belirtiler ve nöbetlerdir. Nörolojik belirtiler arasında duyusal değişiklikler, çoklu kraniyal sinir tutulumu, kuadripleji ve parapleji, distoni ve koreiform hareketler, ataksi, nistagmus, mesane tutulumu, konuşma bozukluğu ve çift görme vardır. Periferik fasiyal sinir felci nadiren eşlik eder. Akut dissemine ensefalomiyelit ile sağ periferik fasiyal sinir felci gelişen 7 yaşındaki bir kız çocuğu olgusunu sunuyoruz. Hastaneye görme azlığı, depresif ruh hali, yürüme bozukluğu ve yüz ifadelerinde bozulma yakınmaları ile başvurdu. Horizontal ve vertikal nistagmus, sağ periferik yüz felci, ataksik yürüyüş ve derin tendon reflekslerinde artış vardı. Beyin omurilik sıvısı (BOS) incelemesi normaldi. Serebral manyetik rezonans görüntülemede (MRG) çoklu beyaz cevher lezyonları görüldü. Yüksek doz metilprednizolon pulse tedavisi ile klinik bulgularda belirgin bir iyileşme gözlemledik.

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“…In the literature, cases with facial paralysis have rarely been reported. However, the association between facial paralysis and ADEM was not explained clearly (12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Akut Dissemine Ensefalomiyelite Bağlı Periferik Fasiyal Sinir Felci Gelişen Bir Çocuk Hasta

Yel¹,

Yarar²,

Kaplan³

et al. 2021

Osmangazi̇ Journal of Medicine

View full text Add to dashboard Cite

show abstract

“…Of these three cases, only one had ADEM associated with primary HIV infection. Patra et al reported a 10-yearold HIV-infected child presenting with monoparesis and progressing to triplegia over four weeks [40]. Serological IgM titers for Toxoplasma gondii, Treponema pallidum, Cytomegalovirus and the hepatitis B, rubella and herpes simplex and hepatitis C viruses, Mantoux test, and the hepatitis B surface antigen were negative.…”

Section: Acute Disseminated Encephalomyelitismentioning

confidence: 99%

Primary neurological manifestations of HIV in children

David¹,

Zaki

Shanbag

2023

J Infect Dev Ctries

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Human immunodeficiency virus type 1 (HIV-1) causes various diseases in different age groups. Neurological manifestations of HIV are common and add to morbidity and mortality. It was previously thought that the central nervous system (CNS) was involved only in the advanced stages of the disease. However, recent evidence supports pathological involvement of the CNS from initial viral entry. Some of the CNS manifestations in children share similarities to neurologic disorders of HIV-infected adult patients, while others are unique to the pediatric population. Many HIV-related neurologic complications seen in adults are rarely encountered in children with AIDS and vice versa. However, with recent advances in the treatment, more HIV-infected children are surviving into adulthood. A systematic review of the available literature was performed to study the manifestations, causes, outcomes, and treatment of primary neurologic disorders in children with HIV. Online databases (Ovid Medline, Embase and PubMed), websites from the World Health Organization, commercial search engines, including Google, and chapters on HIV in standard textbooks of pediatrics and medicine were reviewed. HIV-associated neurological syndromes can be classified into four types: primary HIV neurological diseases, treatment-related neurological diseases, adverse neurological effects of antiretroviral therapy and secondary/opportunistic neurological illness. These conditions are not mutually exclusive and may co-exist in a given patient. This narrative review will focus mainly on the primary neurological manifestations of HIV in children.

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“…ADEM presents with multiple manifestations including encephalopathy coupled with evidence of multifocal lesions of demyelination on neuroimaging. ADEM in children has been reported following exanthematous viral infections, systemic infections or recent vaccinations and is postulated to be due to the immune system dysregulation 1. Although ADEM can occur at all ages, it is most commonly reported in children and adolescents with an incidence rate of 8 per 1 000 000 people per year 2.…”

Section: Introductionmentioning

confidence: 99%

Unusual case of cerebral demyelination and bilateral optic neuritis in an infant with suppurative BCG lymphadenitis

Anandakrishnan¹,

Khoo

2018

BMJ Case Reports

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Cerebral demyelination and optic neuritis are often seen in children with acute disseminated encephalomyelitis following various infections and immunisations. An eight month old girl presented with a left axillary lymph node swelling and an erythematous lace-like rash over her cheeks and trunk. She then developed acute encephalopathy, bilateral nystagmus, right hemiparesis and left facial nerve palsy. Her electroencephalogram showed an encephalopathic process and visual evoked response study were grossly abnormal. Her MRI brain showed hyperintensities in the midbrain, pons and bilateral cerebellar peduncles. She was treated as postinfectious cerebral demyelination with intravenous antibiotics, methylprednisolone and immunoglobulin. Left axillary lymph node excision biopsy and GeneXpert test detected Mycobacterium tuberculosis complex that prompted initiation of antituberculous therapy. Her chest X-ray and cerebrospinal fluid examinations for tuberculosis were normal. She showed significant recovery after 2 weeks. This case illustrates a rare presentation of cerebral demyelination and bilateral optic neuritis following suppurative BCG lymphadenitis.

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Acute disseminated encephalomyelitis: Extremely rare presentation of pediatric human immunodeficiency virus infection

Cited by 9 publications

References 12 publications

Akut Dissemine Ensefalomiyelite Bağlı Periferik Fasiyal Sinir Felci Gelişen Bir Çocuk Hasta

Akut Dissemine Ensefalomiyelite Bağlı Periferik Fasiyal Sinir Felci Gelişen Bir Çocuk Hasta

Primary neurological manifestations of HIV in children

Unusual case of cerebral demyelination and bilateral optic neuritis in an infant with suppurative BCG lymphadenitis

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