A Rare Pediatric Encounter: Transverse Myelitis With Subacute Bilateral Lower Extremity Weakness

Abstract

This case report provides a comprehensive overview of a rare instance of transverse myelitis (TM) in an 11-year-old male who presented with subacute bilateral lower extremity weakness, sensory loss, and bowel/bladder dysfunction. Diagnostic evaluations, including MRI and cerebrospinal fluid (CSF) analysis, confirmed TM. Management with high-dose intravenous corticosteroids and rehabilitative therapies led to symptom stabilization and modest recovery, although some permanent deficits are anticipated. The report highlights the importance of prompt diagnosis and intervention in pediatric patients with acute neurologic symptoms localized to the spinal cord. It contributes to the existing literature by detailing the clinical and diagnostic features of pediatric TM, aiding in early recognition and management to minimize permanent disability. Future research should focus on understanding the underlying pathophysiology with a view to developing targeted therapies.

Keywords: diagnostic evaluations; high-dose intravenous corticosteroids; pediatric; thoracic spinal cord; transverse myelitis.

Figure 1. MRI of the whole spinal cord without IV contrast

The image showed a long segment of abnormal T2W and FLAIR hyperintense signals in the thoracic cord from T5 to T11 MRI: magnetic resonance imaging; FLAIR: Fluid-attenuated Inversion-Recovery