Moyamoya disease in a 5-year child secondary to MOG antibody-positive cerebral cortical encephalitis.

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Child's Nervous System Pub Date : 2024-09-01 Epub Date: 2024-05-24 DOI:10.1007/s00381-024-06470-0
Mahesh Venkatachari, K S Ashwanth, Yugandhar Samireddypalle, Thirunavukkarasu Arun Babu
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Abstract

A 5-year-old girl presented with complaints of fever, left-sided hemiparesis, and left upper motor neuron facial nerve palsy following oral polio booster dose vaccination. She had a past history of fever with altered sensorium with complete resolution at 3 years of age. Cerebrospinal fluid evaluation and stool examination were inconclusive. MRI with MRA showed T2 hyperintensities of the right fronto-temporo-parietal cortex with diffusion restriction and occlusion of bilateral internal carotid arteries and collateral formation suggestive of Moyamoya disease with cerebral cortical encephalitis. Evaluation of encephalitis revealed positivity for anti-myelin oligodendrocyte (MOG) antibodies. She showed a good response to intravenous immunoglobulin and pulse steroids with resolution of encephalitis and facial nerve palsy and improvement in the power of the left side of the body. We presume that the Moyamoya disease in this case is possibly secondary to myelin oligodendrocyte antibody-associated disease.

Abstract Image

一名 5 岁儿童继发于 MOG 抗体阳性大脑皮质脑炎的莫亚莫亚病。
一名 5 岁女孩口服脊髓灰质炎加强免疫后出现发热、左侧偏瘫和左上运动神经元面神经麻痹。她既往有发热史,并伴有感觉改变,3 岁时症状完全缓解。脑脊液评估和粪便检查均无结果。核磁共振成像(MRA)显示,右侧额颞顶叶皮层T2高密度,弥散受限,双侧颈内动脉闭塞,侧支形成,提示Moyamoya病合并大脑皮层脑炎。脑炎评估显示抗髓鞘少突胶质细胞(MOG)抗体阳性。她对静脉注射免疫球蛋白和脉冲类固醇的反应良好,脑炎和面神经麻痹得到缓解,左侧肢体的力量也有所改善。我们推测该病例的莫亚莫亚病可能是继发于髓鞘少突胶质细胞抗体相关疾病。
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来源期刊
Child's Nervous System
Child's Nervous System 医学-临床神经学
CiteScore
3.00
自引率
7.10%
发文量
322
审稿时长
3 months
期刊介绍: The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.
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