Humbertclaude V, Tourtet S, Semprino M, Roubertie A, Rivier F, Leboucq N, Astruc J, Echenne B
Service de neuropédiatrie, centre hospitalier universitaire Saint-Eloi, avenue Bertin-Sans, 34295 Montpellier, France.
Arch Pediatr. 2001 Mar;8(3):282-5. doi: 10.1016/s0929-693x(00)00196-2.
Acute transverse myelitis is a rare disorder in childhood. It usually occurs as a post-infectious disease, but a precise infectious agent is identified in only 20% of cases.
The diagnosis of acute transverse myelitis was made in a 5.5-year-old girl who initially presented with left Claude-Bernard-Horner syndrome and meningitis. A few days later, motor and sensory tetraparesia with bladder dysfunction was observed. Magnetic resonance imaging showed a diffuse lesion in the medulla, with a hypersignal in the T2 and a hyposignal in the T1 sequences. Serum analysis showed the presence of a viral infection due to the lymphocytic choriomeningitis (LCM) virus. The outcome was marked by complete recovery of the sensorimotor deficit, but a persistence of the left Claude-Bernard-Horner syndrome.
In rare cases, the LCM virus is responsible for myelitis. In the present case, the Claude-Bernard-Horner syndrome was secondary to the cervico-medullary lesion. Recent reports in the literature have been discussed, in particular as regards the use of immunomodulatory therapy, which clearly improves patient prognosis.
急性横贯性脊髓炎在儿童时期是一种罕见疾病。它通常作为感染后疾病发生，但仅在20%的病例中能确定确切的感染病原体。
一名5.5岁女孩被诊断为急性横贯性脊髓炎，她最初表现为左侧Claude - Bernard - Horner综合征和脑膜炎。几天后，观察到伴有膀胱功能障碍的运动和感觉性四肢轻瘫。磁共振成像显示延髓有弥漫性病变，在T2序列中呈高信号，在T1序列中呈低信号。血清分析显示存在由淋巴细胞性脉络丛脑膜炎（LCM）病毒引起的病毒感染。结果是感觉运动功能缺损完全恢复，但左侧Claude - Bernard - Horner综合征持续存在。
在罕见情况下，LCM病毒可导致脊髓炎。在本病例中，Claude - Bernard - Horner综合征继发于颈髓病变。本文讨论了文献中的近期报道，特别是关于免疫调节治疗的应用，其明显改善了患者预后。
