Carol Stefannia Leguizamon Niño, N/A, PT
Physical Medicine and Rehabilitation Resident
Departamento de Medicina Física y Rehabilitación, Facultad de Medicina, Universidad Nacional de Colombia
BOGOTA, Distrito Capital de Bogota, Colombia
Yury Gorety Medina Rojas, n/a
Physical Medicine and Rehabilitation Resident
Departamento de Medicina Física y Rehabilitación, Facultad de Medicina, Universidad Nacional de Colombia
BOGOTA, Distrito Capital de Bogota, Colombia
Luisa F. Gómez Ibáñez, N/A, MD
RESIDENT PHYSICAL MEDICINE AND REHABILITATION
Universidad Nacional de Colombia- Centro de Investigacion en Fisiatria y Electrodiagnostico - CIFEL
Bogota, Distrito Capital de Bogota, Colombia
Low-grade myxopapillary ependymoma
Case Description:
A 12 years old female, who presents clinical picture of one year ago consists in lower limbs. This pain was waking up her in the night. Sinche 6 months ago she has presented new symptoms as frequently falling on the floor, instability with gait and difficult upper and down ladders. The physical examination found lower limb areflexia and bilateral foot drops, paraparesis and mild muscle hypertrophy. These symptoms proceed to alarm signs, so order contrasted lumbosacral spine (MRI) and electrodiagnostic studies (EDX). The results in MRI observe the injury expansive that occupies the central canal, intradural and extramedullary since L1-L2.The EDX report radiculopathy L5-S1 in phase bilateral active .She was subsequently taken to resection of the lesion and decompression of cauda equina roots. And pathology report shows low grade myxopapillary ependymoma. As a sequel patient had bilateral foot drop, bladder and neurogenic bowel and depressive and anxious affective symptoms. The lower limb pain in children should have a clinical approach that allows recognizing signs and symptoms that guide the physician regarding possible differential diagnoses, assuming that not all pain in the limbs is secondary to growth. Growing pain is characterized as episodic, recurrent and self-limited in preschool and early school-age children, usually affecting the lower extremities symmetrically and usually occurring at night. The physiatrist considered a sensorimotor polyneuropathy which has a reported prevalence of 1:2500, being the most common genetic neuropathy, other differential diagnoses such as radiculopathy, congenital malformations and tumors can be considered. Early diagnosis and treatment is essential in order to improve patient outcomes and prognosis. Although lower limb pain in children may seem routine, it is essential to perform a thorough evaluation to identify possible differential diagnoses.
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