Chronicle of a Foretold Intersection: Mycoplasma pneumoniae and Brown- Séquard Syndrome
DOI:
https://doi.org/10.46531/sinapse/CC/198/2026Keywords:
Brown-Séquard Syndrome/etiology, Child, Mycoplasma pneumoniae, Pneumonia, Mycoplasma/complicationsAbstract
Mycoplasma pneumoniae is a frequent cause of community-acquired respiratory infection in children but can also produce neurological complications. We report a 9-year-old child who developed neck pain followed by right hemiparesis and contralateral sensory loss, compatible with a Brown-Séquard-like presentation. Brain imaging was normal; spinal magnetic resonance imaging (MRI) showed a focal, right-lateral, C2–C4 T2-hyperintense lesion without contrast enhancement, consistent with myelitis. Respiratory multiplex PCR and serology supported recent M. pneumoniae infection. The patient improved substantially after corticosteroids, targeted antibiotics and rehabilitation, with near-complete functional recovery and no recurrence of disease. Serum MOG-IgG and AQP4-IgG were negative, and neuroimaging did not reveal features typical of MOGAD or NMOSD, helping exclude primary demyelinating disease. This case highlights M. pneumoniae myelitis presenting as a Brown-Séquard syndrome in childhood and underscores the importance of a structured differential diagnosis to guide timely and etiology-specific management.
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Copyright (c) 2024 Catarina Faria Tavares, Mariana Costa, Joana Pinto, Joana Amaral, Filipe Palavra
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