Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
권호 표지
DOI QR코드

DOI QR Code

수두 감염 후 발생한 급성 횡단성 척수염 1예

A case of acute transverse myelitis following chickenpox

  • 김민영 (순천향대학교 의과대학 소아과학교실) ;
  • 서은숙 (순천향대학교 의과대학 소아과학교실)
  • Kim, Min Young (Department of Pediatrics, College of Medicine, Soonchunhyang University) ;
  • Suh, Eun Sook (Department of Pediatrics, College of Medicine, Soonchunhyang University)
  • 투고 : 2008.08.11
  • 심사 : 2008.11.06
  • 발행 : 2009.03.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

급성 횡단성 척수염은 갑자기 발생하는 하지의 진행성 쇠약과 감각 장애가 특징이며, 대부분의 환자가 선행하는 바이러스 감염 증상의 병력을 가진다. 원인이 되는 선행 바이러스는 Epstein-Barr 바이러스, 헤르페스, 인플루엔자, 풍진, 볼거리, 수두 바이러스 등이 있다. 대개 발병 1주 내에 회복을 보이기 시작하지만 수 주 또는 수 개월 동안 지속되는 경우도 있으며, 방광 기능 장애와 하지 쇠약감 등의 후유증이 남을 수 있는 소아에서 비교적 발병이 드문 질환이다. 저자들은 수두를 앓고 난 뒤 전신 마비를 주소로 내원하여 척수 자기공명영상에서 횡단성 척수염을 진단받고, 치료 후 경미한 방광 기능 장애만 남고 거의 완전한 회복을 보인 1예를 경험하였기에 보고하는 바이다.

Acute transverse myelitis (ATM) in most patients is characterized by an abrupt onset of progressive weakness and sensory disturbance in the lower extremities with a preceding viral infection such as Epstein-Barr, herpes simplex, influenza, mumps and Varicella-zoster viruses (VZV). Although less frequent, some residual deficits including bladder dysfunction or weakness in the lower extremities may follow ATM, from which recovery usually begins within the first week of the onset of symptoms. In this report, we describe the case of a 9-year-old girl who experienced ATM following chickenpox and had bladder dysfunction as a sequela.

키워드

참고문헌

  1. Krishnan C, Kaplin AZ, Deshpande DM, Pardo C, Kerr DA. Transverse myelitis: pathogenesis, diagnosis and treatment. Front Biosci 2004;9:1483-99 https://doi.org/10.2741/1351
  2. Syed AM, Shahnaz I. Acute transverse myelitis in children. J Ayub Med Coll Abbottabad 2006;18:90-2
  3. Al Deeb SM, Yaqub BA, Bruyn GW, Biary NM. A localized form of postinfectious encephalomyelitis. Brain 1997;120: 1115-22 https://doi.org/10.1093/brain/120.7.1115
  4. Celik Y. Transverse myelitis caused by varicella. Clin Neurol Neurosurg 2001;103:260-1 https://doi.org/10.1016/S0303-8467(01)00166-4
  5. Vesna VB, Mario H, Marko B, Branko M, Marina B. The differential diagnosis of acute transverse myelitis. Clin Neruol Neurosurg 2006;108:278-83 https://doi.org/10.1016/j.clineuro.2005.11.008
  6. Berman M, Feldman S, Alter M, Ziber N, Kahana E. Acute transverse myelitis: incidence and etiologic considerations. Neurology 1981;31:966-71 https://doi.org/10.1212/WNL.31.8.966
  7. LaRovere KL, Raju GP, Gorman MP. Postvaricella acute transverse myelitis in a previously vaccinated child. Pediatr Neurol 2008;38:370-2 https://doi.org/10.1016/j.pediatrneurol.2008.02.002
  8. Pierre D, Henri H, Beatrice H, Brahim T, Pierre L, Gilbert H, et al. Acute transverse myelitis in children: clinical course and prognostic factors. Child Neurol 2003;18:401-6 https://doi.org/10.1177/08830738030180060601
  9. Tanaka ST, Stone AR, Kurzrock EA. Transverse myelitis in children: long-term urological outcomes. J Urol 2006;175: 1865-8 https://doi.org/10.1016/S0022-5347(05)00929-8
  10. Banwell BL. The long (-itudinally extensive) and the short of it: transverse myelitis in children. Neurology 2007;68: 1447-9 https://doi.org/10.1212/01.wnl.0000264553.99997.45
  11. Kerr DA, Avetev H. Immunopathogenesis of acute transverse myelitis. Curr Opin Neurol 2002;15:339-47 https://doi.org/10.1097/00019052-200206000-00019
  12. McCarthy JT, Amer J. Postvaricella acute transverse myelitis: A case presentation and review of the literature. Pediatrics 1978;62:202-4
  13. Pidcock FS, Krishnan C, Crawfor TO, Salorio CF, Trovato M, Kerr DA. Acute transverse myelitis in childhood: center- based analysis of 47 cases. Neurology 2007;368:1447-9
  14. Vidwan P. Acute transverse myelitis. AM report 2008 Mar 7; Available from: URL://www.med.unc.edu/medicine/web/3.7.08%20TM%20Vidwan.ppt
  15. Kalita J, Shah S, Kapoor R, Misra UK. Bladder dysfunction in acute transverse myelitis: magnetic resonance imaging and neurophysiological and urodynamic correlations. J Neurol Neurosurge Psychiatry 2002;73:154-9 https://doi.org/10.1136/jnnp.73.2.154
  16. Tartaglino LM, Croul SE, Flanders AE, Sweeney JD, Schwartzman RJ, Liem M, et al. Idiopathic acute transverse myelitis: MR imaging findings. Radiology 1996;201:661-9
  17. De Seze J, Lanctin C, Lebrun C, Malikova I, Papeix C, Wiertlewski S, et al. Idiopathic acute transverse myelitis: Application of the recent diagnostic criteria. Neurology 2005; 65:1950-3 https://doi.org/10.1212/01.wnl.0000188896.48308.26
  18. Choi KH, Lee KS, Chung SO, Park JM, Kim YJ, Kim HS, Idiopathic transverse myelitis: MR characteristics. AJNR Am Neuroradiol 1996;17:1151-60
  19. Sebire G, Hollenberg H, Meyer L, Huault G, Landrieu P, Tardieu M. High dose methylprednisolone in severe acute transverse myelopathy. Arch Dis Child 1997;76:167-8 https://doi.org/10.1136/adc.76.2.167
  20. Kopyta I, Wojaczska-Stanek K, Marszal I. Chickenpox- neurological complications in children. Wiad Lek 2007;60: 470-4