Neuromyelitis Optica in Children after Steroid Therapy.

Lee, Kyung Won; Lee, Seok Joon; Lee, Jong Hyuck

Case Report

Journal of the Korean Ophthalmological Society 2004;45(12):2088-2092.
Published online December 1, 2004.

Neuromyelitis Optica in Children after Steroid Therapy.

Kyung Won Lee, Seok Joon Lee, Jong Hyuck Lee

Department of Ophthalmology, Wonju Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea. eyesj@wonju.yonsei.ac.kr

스테로이드 요법 후 발생한 소아 시신경척수염

이경원 ( Kyung Won Lee ) , 이석준 ( Seok Joon Lee ) , 이종혁 ( Jong Hyuck Lee )

Abstract

PURPOSE
Neuromyelitis optica (Devic's disease) is a rare clinical syndrome of unknown etiology in which unilateral or bilateral optic neuritis and transverse myelitis occur within an 8-week time interval. It is a disorder that occurs more commonly in adults than in children. The authors report a case of neuromyelitis optica in a patient who had been treated for transverse myelitis with steroid. METHODS: An 11-year-old female who had been treated for transverse myelitis with steroids for 2 weeks developed visual loss in her left eye with viral prodromes. An afferent pupillary defect was noticed and papilledema and leakage from the optic disc were noticed on fundus examination and fluorescein angiography. We confirmed neuromyelitis optica. RESULTS: Symptoms were improved with high-dose corticosteroid therapy but the visual field remained decreased. CONCLUSIONS: The prognosis of neuromyelitis optica is better in children than in adults. It was better that the child with transverse myelitis had undergone ophthalmologic evaluation and close observation for more than 8 weeks. When optic neuritis was developed, high dose steroid therapy was performed for a sufficient period.

Key Words: Neuromyelitis optica;Optic neuritis;Steroid therapy;Transverse myelitis