Neuromyelitis Optica in Children after Steroid Therapy

ABSTRACT

PURPOSE: Neuromyelitis optica (Devic's disease) is a rare clinical syndrome of unknown etiology in which unilateral or bilateral optic neuritis and transverse myelitis occur within an 8-week time interval. It is a disorder that occurs more commonly in adults than in children. The authors report a case of neuromyelitis optica in a patient who had been treated for transverse myelitis with steroid. METHODS: An 11-year-old female who had been treated for transverse myelitis with steroids for 2 weeks developed visual loss in her left eye with viral prodromes. An afferent pupillary defect was noticed and papilledema and leakage from the optic disc were noticed on fundus examination and fluorescein angiography. We confirmed neuromyelitis optica. RESULTS: Symptoms were improved with high-dose corticosteroid therapy but the visual field remained decreased. CONCLUSIONS: The prognosis of neuromyelitis optica is better in children than in adults. It was better that the child with transverse myelitis had undergone ophthalmologic evaluation and close observation for more than 8 weeks. When optic neuritis was developed, high dose steroid therapy was performed for a sufficient period.