Pittard Andrew, Abramo Thomas J, Arnold Donald H
Departments of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
Pediatr Emerg Care. 2009 Aug;25(8):525-8. doi: 10.1097/PEC.0b013e3181b0a443.
Difficulty swallowing is a common presenting complaint among children seen in the emergency department. We report a case of a male child who presented with difficulty swallowing as the first manifestation of acute disseminated encephalomyelitis and review the pathogenesis and clinical manifestations of this disease. Acute disseminated encephalomyelitis is typically a monophasic, postinfectious, demyelinating disease that presents most often with encephalopathy and acute or subacute, multifocal neurologic deficits. The case demonstrates the importance of considering alternate diagnoses when presented with a patient having a common symptom for which evaluation does not provide a plausible cause.
吞咽困难是急诊就诊儿童中常见的主诉。我们报告一例以吞咽困难为急性播散性脑脊髓炎首发表现的男童病例，并回顾该疾病的发病机制和临床表现。急性播散性脑脊髓炎通常是一种单相、感染后脱髓鞘疾病，最常表现为脑病以及急性或亚急性多灶性神经功能缺损。该病例表明，当面对有常见症状但评估未发现合理病因的患者时，考虑其他诊断的重要性。
