A Child With Difficulty SwallowingPittard, Andrew MD*; Abramo, Thomas J. MD*†; Arnold, Donald H. MD, MPH*†Pediatric Emergency Care: August 2009 - Volume 25 - Issue 8 - p 525-528 doi: 10.1097/PEC.0b013e3181b0a443 Illustrative Cases Abstract Author Information 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: email@example.com). Sources of Support: None. Conflicts of Interest: None. © 2009 Lippincott Williams & Wilkins, Inc.