title: Acute disseminated encephalomyelitis without optic neuritis followed by optic neuritis in a child due to the sudden cessation of steroid therapy.
abstract: Acute disseminated encephalitis (ADEM) is an autoimmune demyelinating disorder of the central nervous system that usually occurs in children after viral infection or vaccination. It is not uncommon for ADEM to be accompanied by optic neuritis. However, ADEM followed by optic neuritis is a rare. We report the case of a 6-year-old girl who initially presented with ADEM (without optic neuritis) due to a live measles, mumps, and rubella vaccine and was treated with intravenous high-dose corticosteroids. After steroid therapy, she recovered neurologically and was not prescribed any medication, including an oral steroid taper, for use after discharge. Three weeks later, she developed unilateral optic neuritis and was again treated with steroid therapy. This is a rare case of ADEM without optic neuritis in a child, followed by optic neuritis due to the sudden cessation of steroid therapy. Further studies and follow-ups are needed to determine whether ADEM followed by optic neuritis can be considered a specific clinical form of this disorder.
authors.affiliation: Department of Ophthalmology, Dong-A University College of Medicine , Busan , Republic of Korea.
authors.forename: Won Yeol
authors.initials: WY
authors.lastname: Ryu
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Sohn
authors.forename: Yoon Hyung
authors.initials: YH
authors.lastname: Kwon
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Jeung
authors.forename: Hee Bae
authors.initials: HB
authors.lastname: Ahn
authors.forename: Woo Chan
authors.initials: WC
authors.lastname: Park
authors.forename: Sae Heun
authors.initials: SH
authors.lastname: Rho
mesh_terms: D002648:Child; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D022542:Measles-Mumps-Rubella Vaccine / Q000009:adverse effects; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D009902:Optic Neuritis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D028761:Withholding Treatment
chemical_list: D005938:Glucocorticoids; D022542:Measles-Mumps-Rubella Vaccine; D008775:Methylprednisolone