A 19-month-old girl is evaluated for a report of refusal to walk, drowsiness, and irritability. She is described as being excessively sleepy, screaming upon waking from naps and having an unsteady gait and refusing to walk. Curiously, this is her third evaluation in the past 2 months for similar concerns.The girl was well until 6 weeks prior when she awoke from a nap and refused to walk. She was noted to be irritable, intermittently waking from sleep screaming and had two episodes of emesis before being evaluated in an emergency department (ED). She had a number of studies performed on this initial presentation including a lumbar puncture. Her symptoms improved after a period of observation and she was discharged to home with a diagnosis of mild acute disseminated encephalomyelitis.
展开▼
