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Aseptic meningitis as initial presentation of acute disseminated encephalomyelitis

Fujio Fujiki1, Yoshio Tsuboi, Tomohiko Hori

  • 1Department of Neurology, Hara-Sanshin Hospital, Fukuoka, Japan.

Journal of the Neurological Sciences
|July 4, 2008
PubMed
Abstract

Insights

Aseptic meningitis can precede acute disseminated encephalomyelitis (ADEM). High fever and hyponatremia are key indicators that may predict ADEM development in patients initially diagnosed with aseptic meningitis.

Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Upper respiratory infections and vaccinations are common triggers for acute disseminated encephalomyelitis (ADEM).
  • Aseptic meningitis is an underrecognized initial manifestation of ADEM.

Purpose of the Study:

  • Compare clinical and laboratory findings in aseptic meningitis with and without ADEM.
  • Identify predictive factors for ADEM development from aseptic meningitis.

Main Methods:

  • Retrospective analysis of 25 adults initially diagnosed with aseptic meningitis.
  • Comparison of clinical features, CSF, and laboratory parameters between isolated aseptic meningitis and ADEM-associated aseptic meningitis groups.

Main Results:

  • Five of 25 patients developed ADEM (AM-ADEM), while 20 had isolated aseptic meningitis (AM-alone).
  • Neurological ADEM symptoms appeared 5-19 days after initial aseptic meningitis symptoms.
  • Sustained high fever (>38°C) and hyponatremia (<135 mEq/l) were more frequent in the AM-ADEM group.

Conclusions:

  • ADEM can develop during hospitalization in patients initially diagnosed with aseptic meningitis.
  • Sustained high fever and hyponatremia are potential predictors for subsequent ADEM development in aseptic meningitis cases.

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