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Serial cerebral CT abnormalities in relapsing acute disseminated encephalomyelitis
1Department of Neurological Sciences, St Bartholomew's Hospital, London, UK.
Journal of Neurology, Neurosurgery, and Psychiatry
|September 1, 1989
Summary
Acute disseminated encephalomyelitis (ADEM) in a child relapsed following Mycoplasma pneumoniae infection. Brain imaging revealed severe lesions disproportionate to symptoms, correlating with clinical changes.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Mycoplasma pneumoniae infections can trigger post-infectious neurological syndromes.
- Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating disease of the central nervous system.
Observation:
- A 7-year-old girl presented with ADEM after a Mycoplasma pneumoniae respiratory infection.
- The patient experienced a relapsing course of illness over two months.
- Cerebral lesions on computed tomography (CT) were severe and extensive, disproportionate to clinical symptoms.
Findings:
- CT scan abnormalities correlated with the patient's fluctuating clinical status.
- The severity of cerebral lesions on CT was notable compared to the observed neurological deficits.
- Relapsing-remitting course suggests complex immunopathogenesis in post-infectious ADEM.
Implications:
- This case highlights the potential for severe and relapsing ADEM following Mycoplasma pneumoniae.
- Discrepancies between imaging and clinical presentation in ADEM warrant careful monitoring.
- Understanding the immunobiology of ADEM is crucial for effective treatment strategies.