Acute disseminated encephalomyelitis following Influenza A pneumonia

Abstract

Acute disseminated encephalomyelitis (ADEM) is an autoimmune demyelinating disorder of the central nervous system and can present following influenza A infections as multifocal neurological deficits. ADEM remains a challenging diagnosis, and high clinical suspicious coupled with laboratory investigations and neuroimaging is required to exclude other primary and secondary demyelinating disorders.

Keywords: Acute disseminated encephalomyelitis; autoimmune demyelinating disorder.

Figure 1

MRI without gadolinium. (A–D) Axial DWI MRI showing diffusion limited restricted diffusion involving right posterolateral aspect, right temporal region, corpus callosum, and right central semiovale. In addition, corpus callosum showing expansive lesions. There was also associated T2‐weighted and fluid‐attenuated inversion recovery (FLAIR) hyperintensities. (E) Sagittal FLAIR MRI showing hyperintense signals involving corpus callosum. (F) Axial T2‐weighted MRI cervical spine showing hyperintense signals involving posterior columns of cervical cord at C2 level.

Figure 2

MRI images without gadolinium showing decreased signals in comparison with Fig. 1.