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A Child With Difficulty Swallowing

Pittard, Andrew MD*; Abramo, Thomas J. MD*†; Arnold, Donald H. MD, MPH*†

doi: 10.1097/PEC.0b013e3181b0a443
Illustrative Cases

Difficulty swallowing is a common presenting complaint among children seen in the emergency department. We report a case of a male child who presented with difficulty swallowing as the first manifestation of acute disseminated encephalomyelitis and review the pathogenesis and clinical manifestations of this disease. Acute disseminated encephalomyelitis is typically a monophasic, postinfectious, demyelinating disease that presents most often with encephalopathy and acute or subacute, multifocal neurologic deficits. The case demonstrates the importance of considering alternate diagnoses when presented with a patient having a common symptom for which evaluation does not provide a plausible cause.

From the Departments of *Pediatrics, and †Emergency Medicine, Vanderbilt University School of Medicine, Nashville, TN.

Reprints: Donald H. Arnold, MD, MPH, Department of Emergency Medicine, Vanderbilt University Medical Center, 700 Oxford House, Nashville, TN 37232-4700 (e-mail: don.arnold@vanderbilt.edu).

Sources of Support: None.

Conflicts of Interest: None.

© 2009 Lippincott Williams & Wilkins, Inc.