Acute disseminated encephalomyelitis in a young patient: A case report

Abstract

The diagnosis of acute disseminated encephalomyelitis (ADEM) is challenging due to the existence of other medical conditions that mimic its symptoms and the lack of precise biomarkers. Timely diagnosis is essential for commencing an appropriate treatment, which enhances the clinical trajectory and long-term prognosis. The purpose of the present study was to emphasize significant concerns, specifically for neurologists and radiologists, due to the difficulties involved in identifying this disorder. Neurologists must have an extensive understanding of the clinical manifestations and constraints of current diagnostic tests. Furthermore, this understanding is equally essential for radiologists, as it serves as the foundation for precise diagnostic interpretations derived from imaging findings. The intricate nature of neurological disorders frequently necessitates a cooperative effort between neurologists and radiologists to guarantee precise diagnosis and efficient therapy strategizing. The present study discusses a case of a male patient who was diagnosed with ADEM based on clinical, biological and imaging evaluations.

Keywords: acute disseminated encephalomyelitis; autoimmune disease; cerebrospinal fluid; immunoglobulin; multiple sclerosis; prognosis.

Figure 1

Cerebral MRI. (A and B) Round and oval shaped lesions (red arrows) with high T2 signal and (C) FLAIR hyperintense, located within the white matter and near the cortex, including the cerebellum (red arrows). (B) Surrounding edema is noted near the bigger lesions. (D) Ring-like or punctate enhancement is demonstrated after contrast medium injection (red arrows).

Figure 2

MRI findings. (A) Brain stem lesions with high T2 (red arrows) and (B) STIR signal (red arrows).

Figure 3

Spine MRI. (A) Sagittal spinal cord MRI, T2 and STIR sequences. (B) Longitudinally extensive lesion at the level of the cervical spinal cord.