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Acute disseminated encephalomyelitis associated with enteroviral infection

Akihiko Saitoh1, Mark H Sawyer, John A D Leake

  • 1Pediatric Infectious Diseases, Children's Hospital San Diego, University of California, San Diego, CA 92123, USA.

The Pediatric Infectious Disease Journal
|January 1, 2005
PubMed

Insights

A 13-year-old boy experienced acute disseminated encephalomyelitis linked to enterovirus. Prompt diagnosis via MRI and cerebrospinal fluid analysis led to substantial symptom improvement and full recovery without lasting neurological effects.

Area of Science:

  • Neurology
  • Pediatrics
  • Infectious Diseases

Background:

  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating disease of the central nervous system.
  • Viral infections, including enteroviruses, are recognized triggers for ADEM in children.
  • Early diagnosis and understanding of triggers are crucial for patient outcomes.

Observation:

  • A 13-year-old male presented with acute onset of severe headache and photophobia.
  • Clinical presentation suggested a possible central nervous system inflammatory process.

Findings:

  • Magnetic resonance imaging (MRI) revealed diffuse high-intensity white matter lesions in the left frontoparietal region, characteristic of demyelination.
  • Enterovirus polymerase chain reaction (PCR) in cerebrospinal fluid confirmed the presence of the virus, establishing an association with ADEM.
  • The patient demonstrated significant clinical improvement without the need for specific antiviral or immunosuppressive therapies.

Implications:

  • This case highlights the potential of enterovirus infection to trigger ADEM in pediatric patients.
  • The findings underscore the importance of neuroimaging and cerebrospinal fluid analysis in diagnosing ADEM.
  • The favorable outcome suggests that prompt identification and supportive care may lead to complete recovery in select ADEM cases, even without specific treatments.

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