All issues > Volume 35(5); 1992

Case Report

J Korean Pediatr Soc. 1992;35(5):671-677. Published online May 15, 1992.

Acute Disseminated Encephalomyelitis

So Young SY Kim¹, Jong Woo JW Bae¹, Byung Churl BC Lee¹

¹Department of Pediatrics, Catholic University Medical College, Seoul, Korea

Abstract

Acute disseminated encephalomyelitis is an uncommon immune mediated inflammatory disorder of the central nervous system. It may be defined as a monophasic encephalitis or myelitis of abrupt onset characterized by symptoms and signs indicative of damage chiefly of the white matter of the brain or spinal cord. The process may be severe and even fatal or mild and evanescent. The cause is uncertain but is believed by some to represent a hypersensitivity, perhaps to myelin basic protein. Headache and delirium may give way to lethargy, coma and seizure. There may be stiffness of the neck, other signs of meningeal irritation, fever, focal signs and spinal cord involvement with flaccid paralysis of all four limbs is common. Tendoin reflexes may be lost initially only to become hyperactive later. Extensor plantar responses and spinter control is generally lost. Sensory loww is variable but may be extensive and severe and nystagmus, ocular palsies, facial palsy ands cerebellar signs. MRI is diagnostic for ADEM because of its high sensitivity in detecting changes in the white matter. It produced asymmetrical multifocal lesions of varying size in the white matter. We have experienced one case of acute disseminated encephalomyelitis. The patient, an 12 years old boy, showed headache, vomiting, mild fever, confusion, paralysis of four extremities and urinary incontience. The diagnosis was confirmed by clinical manifestations, laboratory findings and typical MRI findings. We treated him with steroid and he discharged without complication at 21th hospital day.

Keywords :Acute disseminated encephalomyelitis