Neurogenic shock due to transverse myelitis with Landry’s acute flaccid paralysis in a child

Abstract

Neurogenic shock is a life-threatening condition mostly associated with cervical and high thoracic spine injury, whereas transverse myelitis leading to neurogenic shock is extremely rare. An 11-year-old boy was admitted to our center with Landry’s acute flaccid paralysis and urinary retention, which led the patient to severe respiratory distress. The test indicated a high level of protein and white blood cells in cerebrospinal fluid. He was diagnosed with transverse myelitis and then treated with methylprednisolone. The patient developed hypotension (63/45 mmHg), bradycardia (60 beats per minute), warm flushed skin, and decreased consciousness as a result of neurogenic shock. Fluid resuscitation, noradrenalin, and atropine were indicated, and the shock was well controlled. This is the first case of neurogenic shock due to transverse myelitis with Landry’s acute flaccid paralysis in a child we have experienced so far. It highlights that neurogenic shock should be considered in patients with acute transverse myelitis with Landry’s acute flaccid paralysis.

Keywords

• shock
• transverse myelitis
• landry’s paralysis