급성 파종성 뇌척수염(Acute Disseminated Encephalomyelitis) 1례

A Case of Acute Disseminated Encephalomyelitis

Acute disseminated encephalomyelitis(ADEM), an acute or subacute inflammatory demyelinating disease of the central nervous system, cause lesions in white matter. Since viral infection. vaccination, or upper respiratory infection frequently precedes the disease, it is also called as postinfectious encephalomyelitis, postvaccinial encephalomyelitis, postvaccinial leukoencephalitis. The pathophysiology is thought to be an autoimmune nature, mainly involving the myelin sheath, and one third of the encephalitis patients are known to develop the disease, more frequent in children than in adults. As the clinical manifestations or laboratory findings is nonspecific ti is difficult to differentiate from acute viral encephalitis, bacterial encephalitis and other demyelinating disease by computed tomography. Therfore it requires to get T2 weighted image by magnetic resonance imaging to diagnoses by the monophasic high signal intensity. It well known to respond high-dose steroids. As the mortality is 10-30% in acute phase, but in most of cases symptom improves in a few weeks to months. However, neurological deficits may be left sometimes. As the magnetic resonance imaging technique is becoming popular. it has reported frequently in recent days. The authors experienced a case on a child who had hand-foot-mouth disease 2 weeks before, had visual difficulty. convulsion and deteriorated into comatous state by the time of his hospitalizations. The patient was diagnosed as acute disseminated encephalomyelitis by magnetic resonance imaging, who was recovered from the disease.