Pediatric Emergency Care

Skip Navigation LinksHome > April 2014 - Volume 30 - Issue 4 > Acute Disseminated Encephalomyelitis Following Meningoenceph...
Pediatric Emergency Care:
doi: 10.1097/PEC.0000000000000107
Illustrative Cases

Acute Disseminated Encephalomyelitis Following Meningoencephalitis: Case Report and Literature Review

Elias, Matthew D. MD*; Narula, Sona MD; Chu, Andrew S. MD*

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Abstract: Meningoencephalitis and acute disseminated encephalomyelitis (ADEM) are both neurological disease processes, but there have been few cases of meningoencephalitis progressing to ADEM in the pediatric population. A case of a 4-year-old girl with an initial diagnosis of meningoencephalitis is presented here, whose initial presentation was manifested by prolonged fever, gray matter signal abnormality on brain magnetic resonance imaging, cerebrospinal fluid pleocytosis, and a markedly irritable mental status. As her neurological examination changed with focal abnormalities, a repeat magnetic resonance imaging demonstrated new areas of both gray and white matter signal abnormality, consistent with ADEM. Her symptoms and imaging findings completely resolved with a course of methylprednisolone. Based on the literature and this current case, it is our recommendation to consider ADEM as a diagnosis if meningoencephalitis is not improving.

© 2014 Lippincott Williams & Wilkins, Inc.


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