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Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis
J Kesselring1, D H Miller, S A Robb
1Multiple Sclerosis NMR Research Group, Institute of Neurology, Queen Square, London, UK.
Abstract:
Brain MRI was performed on 12 patients with acute disseminated encephalomyelitis (ADEM). Multifocal white matter lesions indistinguishable from those seen in multiple sclerosis (MS) were found in 10. In 5 there were rather extensive symmetric abnormalities in the cerebral (2) or cerebellar white matter (2), or basal ganglia (1). Follow-up MRI after intervals of 2 wks to 18 months demonstrated partial resolution of the abnormalities, but some persisting lesions. New MRI lesions were found at follow-up in only 1 case after an interval of 2 wks. Serial MRI makes a useful contribution to the distinction between MS and ADEM.
Insights
Brain MRI scans revealed white matter lesions in acute disseminated encephalomyelitis (ADEM) patients that mimic multiple sclerosis (MS). Serial MRI aids in differentiating these conditions.
Area of Science:
- Neurology
- Radiology
- Neuroimmunology
Background:
- Distinguishing between acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) is crucial for appropriate patient management.
- Brain Magnetic Resonance Imaging (MRI) is a key diagnostic tool in evaluating demyelinating diseases.
Observation:
- MRI scans of 12 patients with ADEM were analyzed.
- Multifocal white matter lesions, similar to those in MS, were observed in 10 patients.
- Extensive symmetric abnormalities were noted in the cerebral white matter, cerebellar white matter, or basal ganglia in 5 patients.
Findings:
- Follow-up MRI scans over 2 weeks to 18 months showed partial resolution of lesions, with some persisting.
- New MRI lesions were identified in only one patient at follow-up after 2 weeks.
Implications:
- Serial MRI examinations are valuable for differentiating ADEM from MS.
- MRI findings in ADEM can overlap significantly with MS, necessitating careful interpretation and follow-up.
- Understanding lesion evolution in ADEM via MRI aids in refining diagnostic criteria.