Open AccessRecurrent acute disseminated encephalomyelitis: A favorable outcome among recurrent brain diseases in pediatric patient
Author(s) -
Anirban Chatterjee,
Supratim Datta
Publication year - 2016
Publication title -
journal of pediatric neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.247
H-Index - 18
eISSN - 1998-3948
pISSN - 1817-1745
DOI - 10.4103/1817-1745.193352
Subject(s) - medicine , acute disseminated encephalomyelitis , unconsciousness , pediatrics , demyelinating disorder , multiple sclerosis , magnetic resonance imaging , neuromyelitis optica , neurological deficit , disease , central nervous system , pathology , surgery , radiology , immunology , anesthesia
Acute disseminated encephalomyelitis (ADEM) is an idiopathic inflammatory demyelinating disease of the central nervous system (CNS) and considered mostly a monophasic course. Recurrence of ADEM is rare entity, posing diagnostic dilemma with multiple sclerosis (MS). There were no definite diagnostic criteria or established treatment for ADEM. International Pediatric MS Study Group laid down first consensus definition. We report a boy presented with recurrent episodes of fever, paraparesis, seizure, and unconsciousness. Magnetic resonance imaging (MRI) brain revealed the recurrence of lesions in the same brain site of the previous event. The first and second events were at age of three and five, respectively, with no neurological deficit, clinically and MRI, in between period of 24 months. We found that he responded dramatically both episodes with intravenous immunoglobulin treatment and no CNS deficit was found on 3-year prospective evaluation to exclude MS. We diagnosed recurrent ADEM.