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Case Reports in Pediatrics
Volume 2013, Article ID 124929, 4 pages
http://dx.doi.org/10.1155/2013/124929
Case Report

Neuromyelitis Optica in Child: Diagnostic and Therapeutic Challenges

1Community Health Centers, Lompoc, CA 93436, USA
2Division of Child Neurology, Department of Pediatrics, University of South Florida, Morsani College of Medicine, Tampa, FL 33606, USA
3Division of Neuroradiology, Department of Radiology, University of South Florida, Morsani College of Medicine, Tampa, FL 33606, USA
4Department of Pediatrics, University of South Florida, Morsani College of Medicine, Tampa, FL 33606, USA

Received 11 October 2013; Accepted 17 November 2013

Academic Editors: Y. Al-Tonbary and M. Moschovi

Copyright © 2013 Karolina Dembinski et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Neuromyelitis optica (NMO) is a rare syndrome of severe inflammatory demyelination of the central nervous system, causing attacks of optic neuritis and transverse myelitis. Although uncommon, attention should be given to the proper identification and management of the affected patients. We present a case of a 13-year-old girl with severe neuromyelitis optica. The patient’s initial presentation consisted of encephalopathy and optic neuritis. Approximately 2 months later, coinciding with the weaning of steroid treatment, she presented with ascending paralysis and respiratory failure. She was seropositive for NMO-IgG. Treatment included intravenous immune globulin, steroids, plasmapheresis, and rituximab and was complemented with proper nutrition, vitamins, minerals, and intense rehabilitation. Two years after the initial presentation and one short relapse, the patient has made a remarkable recovery without neurologic deficit. This report underscores the difficulty in making the initial diagnosis, choosing the best treatment, and the need for more streamlined pediatric guidelines for diagnosis, treatment, and prevention of relapses of pediatric NMO.