[Magnetic resonance imaging and clinical features in adults with monophasic demyelinating disease. Acute disseminated encephalomyelitis or a variant of multiple sclerosis?].
Acute disseminated encephalomyelitis (ADEM) is a widespread monophasic inflammatory disease affecting the central nervous system, that usually follows an infection or vaccination. In this study, we present an analysis of magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) and clinical aspects in four patients with clinical diagnosis of ADEM. The presence of MRI demyelinating lesions was crucial, but not in itself sufficient for definitive diagnosis. Clinical and MRI follow up, in order to exclude new lesions and to reevaluate the former ones, as well as CSF, were important for the differential diagnosis with other demyelinating diseases, particularly multiple sclerosis. In addition, we have shown that early treatment with methylprednisolone after the initial symptoms was effective for improving clinical manifestations as well as for reducing MRI lesions.
Reis
F
F
Faculdade de Ciências Médicas (FCM) da Universidade Estadual de Campinas (UNICAMP), Brasil.
Kobayashi
E
E
Maciel
E P
EP
Zanardi
V de A
Vde A
Netto
J R
JR
Damasceno
B P
BP
Cendes
F
F
D000208:Acute Disease; D000328:Adult; D003711:Demyelinating Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004673:Encephalomyelitis, Acute Disseminated / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000175:diagnosis; D012189:Retrospective Studies
D005938:Glucocorticoids; D008775:Methylprednisolone