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Unusal Cinical Cases That Mimic Acute Disseminated Encephalomyelitis

Ozgur Duman ; Department of Child Neurology, Faculty of Medicine, Akdeniz University, Turkey
Vedat Ali Yurekli ; Department of Neurology, Faculty of Medicine, Süleyman Demirel University, Turkey
Pinar Gencpinar ; Department of Child Neurology, Faculty of Medicine, Akdeniz University, Turkey
Kamil Karaali ; Department of Radiology, Faculty of Medicine, Akdeniz University, Turkey
Hakan Gumus ; Department of Child Neurology, Faculty of Medicine, Erciyes University, Turkey
Cetin Okuyaz ; Department of Child Neurology, Faculty of Medicine, Mersin University, Turkey
Volkan Hazar ; Department of Pediatric Hematology/Oncology and BMT Unit, Faculty of Medicine, Akdeniz University, Antalya, Turkey
Senay Haspolat ; Department of Child Neurology, Faculty of Medicine, Akdeniz University, Turkey

Sažetak

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated monophasic inflammatory demyelinating disorder of the central nervous system which poses a diagnostic challenge. We report on six cases of different etiologies that mimicked the clinical and radiologic
findings of ADEM. The cases were collected from four different reference hospitals in Turkey. The same radiologist from the Akdeniz University Faculty of Medicine examined the magnetic resonance images of all patients. Three (50%) patients had antecedent infections. Initial symptoms of the patients were as follows: fever in 50%, altered consciousness in 33.3% and convulsions in 16.7% of patients. Neurologic examination showed long tract signs in 83.3%, ataxia in 50% and altered consciousness in 50% of patients. Cerebrospinal fluid examination revealed lymphocytic pleocytosis
only in case 6. Four patients received steroid pulse therapy and one of these initially underwent intravenous immunoglobulin therapy. The patients’ definitive diagnoses were as follows: paraspinal neuroblastoma-associated paraneoplastic syndrome; histiocytic sarcoma; mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes; and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in one patient each, while two patients had hemophagocytic syndrome. The present case series demonstrated difficulties in diagnosing ADEM while revealing extremely rare disorders that mimic ADEM radiologically and clinically.

Ključne riječi

Encephalomyelitis, acute disseminated; Child; Diagnosis, differential; Case reports

Hrčak ID:

148959

URI

https://hrcak.srce.hr/148959

Datum izdavanja:

1.11.2015.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.891 *