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Adult Onset Acute Disseminated Encephalomyelitis: A Case Report

João R Corrêa1, Ana P Silva1, Joana Coelho1

  • 1Internal Medicine, Centro Hospitalar Universitário Cova da Beira, Covilhã, PRT.

Cureus
|November 27, 2024
PubMed

Insights

Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune brain disorder. Prompt diagnosis and high-dose glucocorticoid treatment led to clinical improvement in a patient with ADEM.

Area of Science:

  • Neuroimmunology
  • Neurology

Background:

  • Acute disseminated encephalomyelitis (ADEM) is a rare, autoimmune demyelinating disorder of the central nervous system.
  • ADEM often mimics other neurological conditions like multiple sclerosis and is triggered by infections.

Observation:

  • A 49-year-old female presented with encephalopathy, motor deficits, dizziness, vertigo, and ataxia.
  • Symptoms followed a recent pharyngitis/sialadenitis.
  • Cerebrospinal fluid showed lymphocytic pleocytosis and elevated protein, with negative cultures and viral studies.

Findings:

  • Brain and cervical spine MRI revealed multiple T2-weighted hyperintense white matter lesions.
  • Diagnostic imaging confirmed lesions in the cerebellar peduncle and internal capsule.
  • The patient was diagnosed with ADEM.

Implications:

  • This case highlights the diagnostic challenges and differential diagnoses in patients with subacute neurological deficits.
  • Early recognition and treatment with high-dose intravenous glucocorticoids are crucial for favorable outcomes in ADEM.
  • Follow-up MRI confirmed the diagnosis and treatment efficacy.
Keywords:
acute ataxiaacute disseminated encephalomyelitis (adem)adult-onsetvitamin-d deficiency• encephalopathy

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