Acute Transverse Myelitis Responsive to Steroid Pulse Therapy in a Two-Year-Eight-Month-Old Boy

抄録

Acute transverse myelitis develops with sudden spinal mobility impairment, symmetric sensory impairment, and rectal or bladder impairment. Although it is commonly treated with steroids, there remains no consistent opinion regarding their effectiveness. We present the case of a two-year, eight-month-old male child in whom steroid pulse therapy was effective. This innately healthy child was brought to hospital with the main complaint of disappearance of spontaneous movements of the bilateral upper extremities. He had developed fever and symptoms of a common cold one month prior to initial examination, at which spontaneous movements of the bilateral upper extremities were absent, and deep tendon reflexes were weak. Spontaneous movements of the lower extremities disappeared the following day, and he developed abasia. Magnetic resonance imaging of the spine showed swelling of the spinal cord from C2 through Th4 levels with high signals on T2-intensified images. Based on the clinical and radiological findings, the child was diagnosed as having transverse myelitis. Steroid pulse therapy was immediately initiated that promptly alleviated the decrease in muscle strength in the lower extremities. After the third course, the condition remitted without sequelae. Early diagnosis and steroid pulse therapy were effective in this young child with acute transverse myelitis.