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Acute disseminated encephalomyelitis presenting as acute psychotic disorder

P Krishnakumar1, M P Jayakrishnan, M Nusrath Beegum

  • 1Department of Pediatrics, Institute of Maternal and Child Health, Medical College, Calicut, Kerala, India. pkrshnakumar@gmail.com

Indian Pediatrics
|January 9, 2009
PubMed

Insights

Acute disseminated encephalomyelitis (ADEM) can manifest as psychotic disorder in children following respiratory infections. This neuroinflammatory condition requires consideration in pediatric differential diagnoses.

Area of Science:

  • Pediatric neurology
  • Neuroimmunology
  • Child psychiatry

Background:

  • Acute psychotic disorder in children is a complex presentation.
  • Infections are known triggers for various neurological conditions in pediatric populations.
  • Differentiating the etiology of acute psychosis in children is crucial for timely and appropriate management.

Observation:

  • Two pediatric patients, a 5-year-old boy and a 10-year-old girl, presented with sudden onset of psychotic symptoms.
  • Both children had experienced an upper respiratory infection approximately one week prior to symptom onset.
  • Cerebral MRI scans revealed findings consistent with acute disseminated encephalomyelitis (ADEM).

Findings:

  • The clinical presentation of acute psychosis in these children was associated with MRI evidence of ADEM.
  • This suggests a potential link between post-infectious neuroinflammation and the development of psychotic symptoms in pediatric cases.
  • ADEM should be considered in the differential diagnosis of acute psychotic disorder in children, particularly after infections.

Implications:

  • Early recognition of ADEM as a cause of pediatric psychosis can lead to prompt diagnosis and treatment.
  • Understanding this association may improve diagnostic pathways for children presenting with acute psychosis.
  • Further research into the neuroimmunological mechanisms underlying ADEM-associated psychosis is warranted.

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