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KMID : 0378020030460010085
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New Medical Journal
2003 Volume.46 No. 1 p.85 ~ p.88
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Distribytion of Lesions in Acute Disseminated Encephlomyelitis
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Abstract
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Purpose: Acute disseminated encephalomyelitis (ADEM) is an uncommon inflammatory demyelinating disease of the central nervous system. Although it is classically considered a white matter disease, gray matter involvement is not uncommon. We review the distribution of lesion in ADEM in children.
Materials and Methods: The 62 MR examinations of 21 patients, who were discharged with the clinical diagnosis of ADEM, were retrospectively reviewed. The patients were aged from 13 months to 12 years old (mean 4.5 years). Locations of abnormal signals in the cerebral and cerebellar white matter, deep gray matter nuclei and brainstem were evaluated. Follow-up MR imagings were done one to 5 (mean 3 times) for 2 weeks to 4 years (mean 3 months) after the initial examination. The presence of enhancement of the lesion was analyzed.
Results: All the patients had white matter abnormalities in the initial MR: subcortical white matter (14), deep white matter (11), internal capsule (8), external capsule (1) and corpus callosum (5). The white matters were symmetrically involved in 11 patients. Sixteen patients (76%) had foci of increased signal intensity of T2WI in the gray matter: thalamus (16), globus pallidus (14), putamen (10). Brain stem was involved in 8 patients. On post contrast image, 6 of 21 patients showed enhancement of some lesions but not all. On follow-up imaging, all patients showed decreased signal intensity and enhancement of the lesions. Seven patients revealed mild brain atrophy and focal high signal intensity of T2WI as a squeal.
Conclusion: Although ADEM commonly involves the white matter of brain, deep gray matter can also be frequently involved.
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