Neuroimaging in postinfectious demyelination and nutritional disorders of the central nervous system

The myelin sheath and oligodendrocytes in the brain may be damaged by autoimmune-mediated inflammatory processes secondary to postinfectious demyelination or nutritional and vitamin deficiency. This article describes acute disseminated encephalomyelitis, acute hemorrhagic leukoencephalitis, acute necrotizing encephalopathy, and tumefactive demyelination as well as osmotic demyelination, Wernicke encephalopathy, Marchiafava-Bignami disease, and subacute combined degeneration of the spinal cord. Although some characteristic MR imaging features allow radiologists to suggest a diagnosis, these may overlap, and images should be interpreted in light of clinical symptoms and laboratory investigations.