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KMID : 0361420080320040472
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Journal of Korean Academy of Rehabilitation Medicine
2008 Volume.32 No. 4 p.472 ~ p.475
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Herpetic Multiphasic Dsseminated Encephalomyelitis
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Seok Hyun
Kim Jun-Lae
Kim Sang-Hyun
Lee Hyuk-Jin
Lee Jang-Bok
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Abstract
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Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating conditions, which is usually monophasic. Recurrent ADEM and multiphasic disseminated encephalomyelitis (MDEM) is much less characterized entity, and its differentiation from multiple sclerosis (MS) poses a diagnostic challenge. We report a case of multiphasic disseminated encephalomyelitis (MDEM). The patient had two episodes of paraparesis and other neurologic symptoms, which were separated by 2 months. The patient presented with fever, headache, mental change, lower extremity weakness, voiding difficulty as well as focal neurologic deficits, which showed good response on steroid and acyclovir. Brain MRI revealed variable sized, multifocal, subcortical white matter lesions with gray matter involvement, and spine MRI revealed high signal intensity from C3 to T9 spinal cord. The CSF study showed elevated protein count and negative oligoclonal band.
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KEYWORD
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Acute disseminated encephalomyelitis, Multiphasic disseminated encephalomyelitis, Herpes Simplex virus
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