Department of Pediatric Medicine, R.G. Kar Medical College, Kolkata, India.
Indian J Pediatr. 2009 Sep;76(9):945-7. doi: 10.1007/s12098-009-0188-9. Epub 2009 Nov 4.
Multiple sclerosis is a demyelinating disease affecting people in early to middle adulthood and is uncommon in childhood. Here we report a patient of multiple sclerosis who presented much before 10 years of age with features suggestive of acute disseminated encephalomyelitis and altered sensorium which is quite different from the features of multiple sclerosis in adults. Diagnosis in this patient was made on the basis of predominant white matter involvement with clinically remitting and relapsing course of the disease on follow up over 3 1/2 years, substantiated by finding multiple areas of demyelinating plaques in magnetic resonance imaging, while visual evoked potential and cerebrospinal fluid study supported demyelination. Hence, children with initial diagnosis of acute disseminated encephalomyelitis need long term follow up as they may develop multiple sclerosis.
多发性硬化症是一种影响早中年人群的脱髓鞘疾病,在儿童中较为罕见。在这里,我们报告了一例多发性硬化症患者,该患者在 10 岁前出现了急性播散性脑脊髓炎和意识改变的特征,与成人多发性硬化症的特征明显不同。该患者的诊断基于主要的白质受累,以及在 3 年半的随访中出现临床缓解和复发的疾病过程,磁共振成像发现了多个脱髓鞘斑块,而视觉诱发电位和脑脊液研究支持脱髓鞘。因此,最初诊断为急性播散性脑脊髓炎的儿童需要长期随访,因为他们可能会发展为多发性硬化症。