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Acute disseminated encephalomyelitis presenting as depressive episode
P Krishnakumar1, M P Jayakrishnan, E Devarajan
1Child Development Services, Institute of Mental Health and Neurosciences (IMHANS), Medical College, Calicut, Kerala, India. krikurp@gmail.com
Indian Journal of Psychiatry
|February 4, 2012
Summary
A child experienced a brief depressive episode following a febrile illness. Brain imaging revealed acute disseminated encephalomyelitis, suggesting a neurological cause for the mood symptoms.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Neuroimmunology
Background:
- Depressive episodes in children can have various etiologies.
- Febrile illnesses can sometimes precede neurological conditions.
- Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system.
Purpose of the Study:
- To report a case of a child presenting with depressive symptoms.
- To investigate the potential neurological underpinnings of the depressive episode.
- To highlight the association between ADEM and neuropsychiatric manifestations.
Main Methods:
- Clinical presentation and history taking.
- Neuroimaging (MRI scan of the brain).
Main Results:
- A 9-year-old girl presented with a 1-week history of depressive episode.
- The onset of depressive symptoms followed a short febrile illness.
- Brain MRI revealed findings consistent with acute disseminated encephalomyelitis.
Conclusions:
- Acute disseminated encephalomyelitis should be considered in the differential diagnosis of new-onset depressive episodes in children, especially after a febrile illness.
- Neuroinflammation may play a role in pediatric mood disorders.
- Early diagnosis and management of ADEM are crucial to prevent long-term neurological sequelae.
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