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Fulminant acute disseminated encephalomyelitis mimicking acute bacterial menigoencephalitis
Author(s) -
Harloff A.,
Rauer S.,
Hofer M.,
Klisch J.,
Els T.
Publication year - 2005
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2004.01015.x
Subject(s) - acute disseminated encephalomyelitis , medicine , fulminant , pleocytosis , meningoencephalitis , brain herniation , encephalomyelitis , cerebrospinal fluid , lesion , pathology , pediatrics , immunology , multiple sclerosis , surgery , disease
Most patients with acute disseminated encephalomyelitis (ADEM) recover quickly under corticosteroid treatment and have a favourable long‐term prognosis. We report on a young woman with acute onset of an extensive and solitary white‐matter lesion in the left hemisphere. Fever, high pleocytosis and elevated protein in cerebrospinal fluid initially suggested bacterial meningoencephalitis. The patient died from brain herniation despite maximal conservative therapy. Histological changes in necropsy were consistent with the diagnosis ADEM. Treatment options of fulminant ADEM are discussed.