title: A child with difficulty swallowing.
abstract: Difficulty swallowing is a common presenting complaint among children seen in the emergency department. We report a case of a male child who presented with difficulty swallowing as the first manifestation of acute disseminated encephalomyelitis and review the pathogenesis and clinical manifestations of this disease. Acute disseminated encephalomyelitis is typically a monophasic, postinfectious, demyelinating disease that presents most often with encephalopathy and acute or subacute, multifocal neurologic deficits. The case demonstrates the importance of considering alternate diagnoses when presented with a patient having a common symptom for which evaluation does not provide a plausible cause.
authors.affiliation: Departments of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Pittard
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Abramo
authors.forename: Donald H
authors.initials: DH
authors.lastname: Arnold
mesh_terms: D000038:Abscess / Q000175:diagnosis; D002648:Child; D003389:Cranial Nerve Diseases / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology*; D003937:Diagnosis, Differential; D004630:Emergencies; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005334:Fever / Q000209:etiology; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D010612:Pharyngitis / Q000209:etiology; D011239:Prednisolone / Q000627:therapeutic use; D012135:Respiratory Sounds / Q000209:etiology
chemical_list: D011239:Prednisolone