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J Pediatr Rehabil Med · Jan 2021
Case ReportsSpinal cord infarction in children: Can gymnastics be a cause?
- Margarida Rodrigues, Gustavo Beça, Ana Almeida, Inês Natário, Filipa Vilabril, Margarida Pereira, José Barreto, Leonor Dias, and Fátima Gandarez.
- Centro de Reabilitação do Norte, Vila Nova de Gaia, Portugal.
- J Pediatr Rehabil Med. 2021 Jan 1; 14 (1): 97-101.
IntroductionSpinal 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 ReportA 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.DiscussionGiven 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.
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