Demyelinating disease of Schilder type in three young South African children: Dramatic response to corticosteroids
Date
1998
Authors
Pretorius M.-L.
Loock D.B.
Ravenscroft A.
Schoeman J.F.
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Abstract
Three young children with the Schilder variant of multiple sclerosis were seen within a 3-year period at our hospital. The diagnosis was made on the basis of the typical (but not pathognomonic) clinical and magnetic resonance imaging (MRI) findings after eliminating other demyelinating and post-infectious disorders of the central nervous system. All three patients were treated with prednisone (2 mg/kg/day), which resulted in complete recovery in one patient and mild and moderate residual hemiparesis in the two other patients, respectively. Corticosteroid therapy was continued until the patients' neurologic condition normalized or no further clinical improvement occurred. No relapses were seen after discontinuation of corticosteroid treatment. Computed tomographic (CT) scan and MRI findings after completion of corticosteroid therapy were equally dramatic and corresponded with the clinical improvement. A strongly positive tuberculin skin test and a positive history of contact with adult tuberculosis in two of our patients raise the possibility of a connection between tuberculosis and Schilder's disease.
Description
Keywords
corticosteroid, dexamethasone, immunoglobulin, prednisone, article, case report, child, clinical feature, computer assisted tomography, corticosteroid therapy, demyelinating disease, female, human, intravenous drug administration, male, nuclear magnetic resonance imaging, oral drug administration, preschool child, priority journal, school child, treatment outcome, Anti-Inflammatory Agents, Brain, Child, Child, Preschool, Diffuse Cerebral Sclerosis of Schilder, Female, Humans, Magnetic Resonance Imaging, Male, Prednisone, South Africa, Tuberculosis
Citation
Journal of Child Neurology
13
5
13
5