Cilostazol in a Child With Moyamoya Disease.
Alizah A Patterson, Sarah K D Vogel, April Sharp et al.
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Case in brief
A 9-year-old girl with moyamoya disease was diagnosed after a large right middle cerebral artery stroke. Following pial synangiosis, she developed frequent transient episodes of dysarthria and left-sided drooling. The episodes persisted despite trials of antiseizure medications and blood pressure augmentation, then abated after cilostazol was added. When episodes recurred, they again subsided after the cilostazol dose was adjusted.
What made this case unusual
The report describes cilostazol use for recurrent transient neurologic events in a child with moyamoya after pial synangiosis, an area where pediatric safety and efficacy were stated to be unknown.
Diagnostic / clinical pearl
In this case, recurrent transient neurologic events after pial synangiosis abated with cilostazol and again subsided after dose adjustment; the report does not establish efficacy or safety in other children.
Why it matters
The case highlights the limited evidence for nonsurgical interventions in pediatric moyamoya and the need for further investigation of cilostazol.