Neurogenic shock due to transverse myelitis with Landry’s acute flaccid paralysis in a child

Q4 Medicine

Romanian Journal of Neurology/ Revista Romana de Neurologie Pub Date : 2022-06-30 DOI:10.37897/rjn.2022.2.16

Kiem Hao Tran, H. Nguyen, Nguyen Loi Vo-Van

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Abstract

Neurogenic shock is a life-threatening condition mostly associated with cervical and high thoracic spine injury, whereas transverse myelitis leading to neurogenic shock is extremely rare. An 11-year-old boy was admitted to our center with Landry’s acute flaccid paralysis and urinary retention, which led the patient to severe respiratory distress. The test indicated a high level of protein and white blood cells in cerebrospinal fluid. He was diagnosed with transverse myelitis and then treated with methylprednisolone. The patient developed hypotension (63/45 mmHg), bradycardia (60 beats per minute), warm flushed skin, and decreased consciousness as a result of neurogenic shock. Fluid resuscitation, noradrenalin, and atropine were indicated, and the shock was well controlled. This is the first case of neurogenic shock due to transverse myelitis with Landry’s acute flaccid paralysis in a child we have experienced so far. It highlights that neurogenic shock should be considered in patients with acute transverse myelitis with Landry’s acute flaccid paralysis.

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儿童横脊髓炎并发兰德里急性弛缓性麻痹所致的神经源性休克

神经源性休克是一种危及生命的疾病，主要与颈椎和胸椎损伤有关，而横脊髓炎导致神经源性休克极为罕见。一名11岁男童因兰德里急性弛缓性麻痹及尿潴留而入住本中心，导致患者出现严重呼吸窘迫。试验表明脑脊液中蛋白质和白细胞含量高。他被诊断为横贯脊髓炎，然后用甲基强的松龙治疗。患者出现低血压(63/45 mmHg)，心动过缓(每分钟60次)，皮肤发热发红，神经源性休克导致意识下降。给予液体复苏、去甲肾上腺素和阿托品，休克得到很好的控制。这是我们迄今为止第一例因横脊髓炎并发兰德里急性弛缓性麻痹而发生神经源性休克的儿童。强调急性横脊髓炎合并兰德里急性弛缓性麻痹患者应考虑神经源性休克。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Romanian Journal of Neurology/ Revista Romana de Neurologie Medicine-Neurology (clinical)

CiteScore

0.40

自引率

0.00%

发文量

审稿时长

4 weeks

期刊介绍： ROMANIAN JOURNAL OF NEUROLOGY (Revista Română de Neurologie), the official journal of the Romanian Society of Neurology, was founded in 2001, being a prestigious scientific journal that provides a high quality in terms of scientific content, but also the editorial and graphic aspect, both through an impartial process of selection, evaluation and correction of articles (peer review procedure), as well as providing editorial, graphic and printing conditions at the highest level. In order to increase the scientific standards of the journal, special attention was paid to the improvement of the quality of the published materials. Guidance articles, clinical trials and case studies are structured in several sections: reviews, original articles, case reports, images in neurology. All articles are published entirely in English. A team of reputable medical professionals in the field of neurology is involved in a rigorous peer review process that complies with international ethics and quality rules in the academic world.