Clinical Reasoning: A 6-Year-Old Girl With Right-Sided Pain and Weakness

Neurology. 2023 Jan 10;100(2):97-102. doi: 10.1212/WNL.0000000000201481. Epub 2022 Oct 18.

Abstract

We outline the case of a 6-year-old girl presenting with a 2-week course of waxing and waning neurologic symptoms, including right-sided pain, weakness, dizziness, and difficulty walking. Her examination was notable for right-sided weakness, hyperreflexia, and dysmetria. Diagnostic evaluation was significant for MRI with numerous T2 hyperintense, T1 hypointense, and T1-enhancing lesions located in the juxtacortical and periventricular regions, corpus callosum, brainstem, and spinal cord; positive CSF oligoclonal bands; negative serum aquaporin-4 immunoglobulin G (IgG) and myelin oligodendrocyte glycoprotein IgG; and positive serum Epstein-Barr viral capsid antigen IgG.

Publication types

  • Case Reports

MeSH terms

  • Brain Stem*
  • Child
  • Clinical Reasoning
  • Female
  • Humans
  • Immunoglobulin G
  • Myelin-Oligodendrocyte Glycoprotein
  • Pain
  • Spinal Cord*

Substances

  • Immunoglobulin G
  • Myelin-Oligodendrocyte Glycoprotein