Longitudinal extensive transverse myelitis with cervical epidural haematoma following dengue virus infection

Choong Yi Fong, Chaw Su Hlaing, Chee Geap Tay, Khairul Azmi Abdul Kadir, Khean Jin Goh, Lai Choo Ong

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Longitudinal extensive transverse myelitis associated with dengue infection is rare with no reported paediatric cases. Methods: We report a 12-year-old girl who presented with flaccid quadriplegia 8 days after onset of acute dengue fever. MRI spine showed T2 hyperintensity associated with epidural hematoma at C3-C6 level of the spinal cord. Transcranial magnetic brain stimulation revealed absent motor evoked potentials bilaterally. We also summarise and compare the reported cases of transverse myelitis associated with dengue infection. Results: Immunomodulatory treatment was given which included pulse methylprednisolone, intravenous immunoglobulin and plasmapharesis. Six months post-admission, there was a good (near-complete) clinical recovery with the repeat MRI showing mild residual hyperintensity at C4 level and complete resolution of epidural haematoma. Conclusion: This is the first reported paediatric case of longitudinal extensive transverse myelitis following dengue infection. It is also the first to illustrate that in patients with concomitant epidural haematoma a good outcome is possible despite not having surgical decompression. Clinicians should be aware of parainfectious dengue-related longitudinal extensive transverse myelitis in children and consider prompt immunomodulatory treatment.

Original languageEnglish
JournalEuropean Journal of Paediatric Neurology
DOIs
Publication statusAccepted/In press - 11 Jan 2015
Externally publishedYes

Fingerprint

Transverse Myelitis
Dengue Virus
Dengue
Virus Diseases
Hematoma
Infection
Pediatrics
Surgical Decompression
Motor Evoked Potentials
Quadriplegia
Transcranial Magnetic Stimulation
Intravenous Immunoglobulins
Methylprednisolone
Spinal Cord
Spine
Brain
Therapeutics

Keywords

  • Demyelination
  • Dengue
  • Paediatric
  • Spinal cord
  • Transverse myelitis

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health

Cite this

Longitudinal extensive transverse myelitis with cervical epidural haematoma following dengue virus infection. / Fong, Choong Yi; Hlaing, Chaw Su; Tay, Chee Geap; Abdul Kadir, Khairul Azmi; Goh, Khean Jin; Ong, Lai Choo.

In: European Journal of Paediatric Neurology, 11.01.2015.

Research output: Contribution to journalArticle

Fong, Choong Yi ; Hlaing, Chaw Su ; Tay, Chee Geap ; Abdul Kadir, Khairul Azmi ; Goh, Khean Jin ; Ong, Lai Choo. / Longitudinal extensive transverse myelitis with cervical epidural haematoma following dengue virus infection. In: European Journal of Paediatric Neurology. 2015.
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