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Acute disseminated encephalomyelitis presenting as ataxic hemiparesis

S Pradhan1, N Pandey1

  • 1Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow - 226 014, India.

Neurology India
|March 7, 2018
PubMed

Insights

Acute disseminated encephalomyelitis (ADEM) can present unusually. This case highlights parainfectious central demyelination with significant MRI findings but mild neurological deficits, emphasizing atypical ADEM presentations.

Area of Science:

  • Neuroscience
  • Immunology
  • Radiology

Background:

  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating disease.
  • ADEM typically follows an infection or vaccination.
  • Rare presentations of ADEM challenge diagnostic criteria.

Purpose of the Study:

  • To describe a rare clinical presentation of ADEM.
  • To correlate clinical findings with neuroimaging in a unique ADEM case.
  • To discuss the implications of atypical ADEM presentations.

Main Methods:

  • Case report of a patient with suspected ADEM.
  • Clinical neurological examination.
  • Magnetic resonance imaging (MRI) of the brain.

Main Results:

  • The patient exhibited a rare clinical profile of ADEM.
  • Temporal analysis suggested parainfectious central demyelination.
  • MRI revealed extensive bilateral demyelinating lesions in the brain white matter, thalami, and brainstem.
  • Clinical symptoms were limited to right ataxic hemiparesis and dysphasia, with preserved cognition and consciousness.

Conclusions:

  • This case underscores the variability in ADEM clinical manifestations.
  • Significant neuroimaging findings can occur with minimal clinical impairment in ADEM.
  • Understanding rare ADEM presentations is crucial for accurate diagnosis and management.

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