재발한 급성 괴사성 뇌병증 1례

A Case of Relapsing Acute Necrotizing Encephalopathy

저자들은 15개월에 급성 괴사성 뇌병증을 않았던 4세 남아에서 발열 및 경한 상기도 감염의 증상 후 갑자기 의식이 나빠지고 전신발작을 일으키며 뇌 MRI상 T2 강조영상에서 고 신호 강도를 보이는, 양측 시상을 대칭적으로 침범하는 원형의 병변이 관찰되었던 재발된 급성 괴사성 뇌병증 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

A 4-year-old boy showed two episodes of encephalitis/encephalopathy involving disturbed consciousness, convulsion, and paresis associated with the elevated levels of protein and no pleocytosis of the cerebrospinal fluid. MRI studies of the brain revealed symmetrical lesions in the brain stem and thalamus at the first episode, and their sizes were regressed. The lesions were enlarged to the previous size in the second episode. These episodes were not followed by an elevation of the anti-viral antibody titer. In the second episode, intravenous methylprednisolone therapy and intravenous immunoglobulin therapy were introduced.