Childhood multiple sclerosis mimicking acute disseminated encephalomyelitis.

Multiple sclerosis is a demyelinating disease affecting people in early to middle adulthood and is uncommon in childhood. Here we report a patient of multiple sclerosis who presented much before 10 years of age with features suggestive of acute disseminated encephalomyelitis and altered sensorium which is quite different from the features of multiple sclerosis in adults. Diagnosis in this patient was made on the basis of predominant white matter involvement with clinically remitting and relapsing course of the disease on follow up over 3 1/2 years, substantiated by finding multiple areas of demyelinating plaques in magnetic resonance imaging, while visual evoked potential and cerebrospinal fluid study supported demyelination. Hence, children with initial diagnosis of acute disseminated encephalomyelitis need long term follow up as they may develop multiple sclerosis.

Cardiac tumour in a newborn.

Primary cardiac tumours are mostly benign and rare in paediatric practice. Here, a male baby was presented with history of birth asphyxia. On examination he was found to have a systolic murmur and was initially thought to be either a case of ventricular septal defect or tricuspid regurgitation due to asphyxial cardiomyopathy. Echocardiography revealed normal LV systolic function, intact interatrial septum and interventicular septum without intracardiac shunt and normal cardiac valve morphology. There was a multilobulated solitary intracardiac mass with a narrow stalk arising from RV free wall. Thus the diagnosis of cardiac tumour was clinched.