Diagnostic features of recurrent acute disseminated encephalomyelitis in adults and literature review

doi:10.3877/cma.j.issn.2095-655X.2022.01.005

Abstract

Abstract:

Objective

To explore the diagnostic features of recurrent acute disseminated encephalomyelitis (ADEM) in adults.

Methods

The clinical data of an adult patient with recurrent ADEM in Neurology Department of Taian Municipal Hospital from May 2018 to May 2020 were retrospectively analyzed. The diagnostic features of ADEM were summarized and relevant literatures were reviewed.

Results

The patient had a history of infection before the onset of 3 episodes, and had dizziness, slurred speech, and unsteady walking in each episode. Blood and cerebrospinal fluid oligoclonal zone(-). Blood and cerebrospinal fluid aquaporin 4 (AQP4) antibody(-), myelin basic protein (MBP) antibody(-), myelin oligodendrocyte glycoprotein (MOG) antibody(-) and ganglioside profile antibody(-). MRI of the brain did not exclude changes in demyelination. There was no obvious enhancement in brain MRI enhancement. MRI arterial spin labeling (ASL) perfusion imaging suggested that the brain was hypoperfused, and demyelinating disease was considered. Magnetic resonance spectroscopy (MRS) conformed to the MRS manifestations of demyelinating lesions. Symptoms improved after hormone shock therapy for 3 episodes.

Conclusion

The clinical manifestations of ADEM are complex and varied, which can be correctly diagnosed by means of serum antibody, imaging and neuroelectrophysiology.

Key words: Acute disseminated encephalomyelitis, Recurrence, Multiple sclerosis, Optic neuromyelitis, Adult

Xue Wang, Mingjuan Zhao, Yongli Fang. Diagnostic features of recurrent acute disseminated encephalomyelitis in adults and literature review[J]. Chinese Journal of Diagnostics(Electronic Edition), 2022, 10(01): 21-25.

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Figures/Tables 5

References 13

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项目	眼震	颅神经损伤	肌力下降	感觉减退	腱反射	病理征	脑膜刺激征
第1次发病	-	+	+	-	减弱	-	+
第2次发病	+	-	-	-	减弱	+	+
第3次发病	+	+	+	+	消失	-	-

项目	眼震	颅神经损伤	肌力下降	感觉减退	腱反射	病理征	脑膜刺激征
第1次发病	-	+	+	-	减弱	-	+
第2次发病	+	-	-	-	减弱	+	+
第3次发病	+	+	+	+	消失	-	-

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