Related Experiment Video

Updated: May 20, 2026

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
26:48

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis

Published on: July 4, 2007

Isolated brain stem lesion in children: is it acute disseminated encephalomyelitis or not?

G Alper1, G Sreedher, G Zuccoli

  • 1Division of Child Neurology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. gulay.alper@chp.edu

AJNR. American Journal of Neuroradiology
|July 7, 2012
PubMed

Insights

Acute demyelinating lesions in the brain stem can be challenging to diagnose in children. This study suggests that some isolated brain stem lesions may represent a rare, localized form of acute disseminated encephalomyelitis (ADEM).

Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Demyelinating Diseases

Background:

  • Isolated brain stem lesions with acute neurological symptoms pose a diagnostic challenge in pediatric patients.
  • While acute disseminated encephalomyelitis (ADEM) often involves the brain stem, solitary lesions are uncommon.

Purpose of the Study:

  • To investigate the characteristics and outcomes of children presenting with inflammatory lesions confined to the brain stem.
  • To determine if these cases represent a distinct clinical entity or a variant of ADEM.

Main Methods:

  • Retrospective review of 6 pediatric patients with brain stem-confined inflammatory lesions.
  • Clinical assessment, neuroimaging (MRI), and diagnostic workup for underlying etiologies.
  • Evaluation of treatment response, particularly to high-dose corticosteroids.

Main Results:

  • Two patients were diagnosed with connective tissue disorders (CNS lupus, localized scleroderma).
  • One case had an undetermined etiology, and three cases showed features of monophasic demyelination.
  • The three monophasic cases exhibited vasogenic edema, responded dramatically to corticosteroids, and achieved full recovery with no relapses.
  • Follow-up MRI in these three cases showed complete lesion resolution.

Conclusions:

  • Monofocal demyelination confined to the brain stem can occur in children.
  • These cases, particularly those with a monophasic course and good response to steroids, are best classified as a localized form of ADEM.
  • ADEM, typically multifocal, can rarely present as a solitary brain stem lesion.

More Related Videos

Scoring Central Nervous System Inflammation, Demyelination, and Axon Injury in Experimental Autoimmune Encephalomyelitis08:17

Scoring Central Nervous System Inflammation, Demyelination, and Axon Injury in Experimental Autoimmune Encephalomyelitis

Published on: February 23, 2024

Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
Arboviral Encephalitis01:25

Arboviral Encephalitis

Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...