title: Recovery after tetraplegia caused by dermal sinus infection: intramedullary abscess and tetraparesis.
abstract: Congenital dermal sinuses result from abnormal neurulation, and are uncommon. A spinal intramedullary abscess secondary to an infected dermoid cyst is very rare, and the functional prognosis is usually quite poor. We report on a 16-month-old child with tetraplegia secondary to intramedullary abscesses because of a dermoid cyst infection associated with a dermal sinus. The abscesses were drained, and the dermoid cyst was removed. Antibiotics were administered for 6 weeks after neurosurgery. The child was followed at a pediatric rehabilitation department. After 1 year, he was able to walk quickly and had regained appropriate upper limb motor function for his age. However, bladder sphincter dyssynergia persisted, requiring intermittent catheterization. This case highlights the importance of early diagnosis for surgical intervention and prolonged antibiotic therapy. Long-term follow-up by a multidisciplinary team allowed for the effective management of related neurologic, orthopedic, and bladder disorders.
authors.affiliation: Service de Médecine Physique et Réadaptation, Centre Hospitalier Régional Universitaire Brest, Hôpital Morvan, Brest, France. laetitia.houx@chu-brest.fr
authors.forename: Laetitia
authors.initials: L
authors.lastname: Houx
authors.forename: Sylvain
authors.initials: S
authors.lastname: Brochard
authors.forename: Sylviane
authors.initials: S
authors.lastname: Peudenier
authors.forename: Phong
authors.initials: P
authors.lastname: Dam Hieu
authors.forename: Olivier
authors.initials: O
authors.lastname: Rémy-Néris
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D016866:Bacteroidaceae Infections / Q000150:complications* / Q000188:drug therapy; D001922:Brain Abscess / Q000150:complications*; D002439:Cefotaxime / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D009068:Movement / Q000502:physiology; D011782:Quadriplegia / Q000209:etiology* / Q000601:surgery; D020127:Recovery of Function / Q000502:physiology*; D016136:Spina Bifida Occulta / Q000150:complications* / Q000188:drug therapy; D013116:Spinal Cord / Q000473:pathology
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole; D002439:Cefotaxime