Jornal de Neurologia e Neurociência

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Abstrato

Pediatric neuromyelitis optica and it management in rural practice in north Togo: About a 13-year-old young girl and review of literature

Léhleng Agba*, Nyinèvi Anayo, Lihanimpo Djalogue, Massaga Dagbe, Kokou Mensah Guinhouya, Vinyo Kumako, Damelan Kombate, Kossivi Apetse, Abide Talabewi, Komi Assogba, Mofou Belo, Ayelola Balogou

Considered for a long time as a particular form of multiple sclerosis (MS), Devic's disease generally occurs in young women between 20 and 40 years old. This neuro-immunological disease can affect children and adolescents. It was the case of a 13-year-old student who came to the clinic with a walking disorder of insidious onset and ascending progression. Guillain-Barré syndrome was the first diagnosis retained but when visual troubles occurred, the medullary MRI and the search for anti Aquaporine-4 (AQP-4) antibodies where done. The medullary MRI showed a hypersignal in T2 weighted extended on 6 vertebrae at the cervical level. The anti-AQP-4 antibody was positive. Devic's disease was then recognized in this young girl who was given intravenous (IV) corticosteroid. The lack of the therapeutic arsenal in our region did not allow the patient to receive plasma exchange and IV immunoglobulin as recommended by the guidelines. However, with corticosteroid therapy at 30 mg/kg/day for 5 days, the neurological disorders stabilized. With Azathioprine as preventive treatment and physiotherapy, the patient improved after 3 months, without complete recovery.