Acute disseminated encephalomyelitis confined to brainstem.
A 21-year-old man was troubled with a subacute history of brainstem involvement and a leukocyte pleocytosis in the cerebrospinal fluid. Magnetic resonance imaging (MRI) demonstrated a massive lesion with Gd enhancement in the pons. Steroid therapy, not antiviral drugs, was dramatically effective for the mass reduction and symptom improvement. Over 4 years no recurrence has been recognized, so this case was diagnosed to be an unusual case of acute disseminated encephalomyelitis (ADEM). ADEM must be included in the differential diagnosis for a brainstem mass in MRI.
Tateishi
K
K
Department of Second Internal Medicine, Tokyo University, Bunkyo-Ku, Hongo 7-3-1, Tokyo 1138655, Japan. ktateish@rinshoken.or.jp
Takeda
K
K
Mannen
T
T
D000208:Acute Disease; D000328:Adult; D001933:Brain Stem; D003287:Contrast Media; D003937:Diagnosis, Differential; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis*; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male
D003287:Contrast Media; D019786:Gadolinium DTPA