Imaging features in acute disseminated encephalomyelitis

Case report


Prahant Bhat1, Hussein Belazi2, Majdi Kara2 and Hamida Elsahli3

1) Libyan Swiss Diagnostic Centre, Tripoli; 2) Children’s Hospital, Tripoli; 3) Paediatric Intensive Care Unit, AlKhadra Hospital, Tripoli

JMJ Vol.4 No. 2 (Autumn) 2005: 146-150


The authors report 3 children with the diagnosis of acute disseminated encephalomyelitis. (ADEM) Diagnosis was based on clinical and radiological findings. The most common presenting symptoms were fever and disturbed consciousness, followed by cranial nerve abnormalities and pyramidal signs. Brain MRI showed hyperintense signals on T2-weighted images, most commonly in the subcortical and periventricular white matter, brainstem, basal ganglia and thalamus. The lesions were bilateral, asymmetrical and highly variable in size and number. A preceding infection was present in 2 of 3 children. Early high-dose corticosteroids were given to all the patients. One child succumbed to the disease. Two children improved on steroid and immunoglobulin therapy but had residual neurological deficits. Early high-dose steroid therapy is an effective treatment in acute disseminated encephalomyelitis.

Keywords: Acute disseminated encephalomyelitis, ADEM, Steroid therapy.
Magnetic Resonance Imaging (MRI)