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Article type: Case Report
Authors: Rodrigues, Margaridaa; * | Beça, Gustavoa | Almeida, Anaa | Natário, Inêsa | Vilabril, Filipab | Pereira, Margaridaa | Barreto, Joséc | Dias, Leonord | Gandarez, Fátimaa
Affiliations: [a] Centro de Reabilitação do Norte, Vila Nova de Gaia, Portugal | [b] Serviço de Medicina Física e de Reabilitação, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal | [c] Serviço de Medicina Física e de Reabilitação, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal | [d] Serviço de Neurologia, Centro Hospitalar Universitário de São João, Porto, Portugal
Correspondence: [*] Corresponding author: Margarida Rodrigues, Centro de Reabilitação do Norte Avenida Infante de Sagres 349. 4405 – 565 Vila Nova de Gaia, Portugal. Tel.: +35 1220901200; E-mail: 90.rodriguesmargarida@gmail.com.
Abstract: INTRODUCTION: Spinal cord infarction (SCI) in children is rare and difficult to diagnose. Fibrocartilaginous embolism (FCE) is probably the underlying cause for some unexplained cases of spinal cord infarcts. Abrupt back pain followed by a progressive syndrome of myelopathy appears to be the typical presentation, with a close temporal relationship between the onset of symptoms and preceding minor trauma. Supportive care and rehabilitation are essential in the treatment of children with SCI. CASE REPORT: A previously healthy 12-year-old girl who practiced acrobatic gymnastics was admitted to a rehabilitation centre 14 days after being diagnosed with an acute anterior SCI with no identified cause. Sensory modality of pin prick and light touch were impaired, with the former more significantly affected. She was not able to run and had difficulty on monopodal standing and performing motor sequencing. Additionally, she mentioned ineffective cough along with flatus incontinence and normal bladder function. After a 4-week multidisciplinary rehabilitation program her neurologic deficits improved. DISCUSSION: Given the patient’s age and clinical presentation, a literature review led to the consideration of FCE as the most likely definitive diagnosis. It should be recognized as a cause of SCI especially in those involved in sport activities, even if previous trauma is denied.
Keywords: Pediatric, spinal cord infarction, fibrocartilaginous embolism, gymnastics, sport, rehabilitation
DOI: 10.3233/PRM-200684
Journal: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 97-101, 2021
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