|
KMID : 1201420130060010032
|
|
Journal of Neurocritical Care
2013 Volume.6 No. 1 p.32 ~ p.35
|
|
|
A Case of Acute Disseminated Encephalomyelitis with Marked Cerebrospinal Fluid Pleocytosis
|
|
Kim Hyung-Jun
Kim Sae-Ro-Mi
Lee Jung-Gon
Lee Kyung-Bok
Roh Hak-Jae
Ahn Moo-Young
|
|
|
Abstract
|
|
|
Background: The diagnosis of acute disseminated encephalomyelitis (ADEM) is based on clinical feature supported by radiologic and laboratory tests. The cerebrospinal fluid (CSF) may show a mild lymphocytic pleocytosis and raised protein.
Case Report: We describe an atypical case of ADEM that a previously healthy 38-year-old women, who showed deep drowsiness, confusion, paraparesis and dysuria from the 10th day after recent upper respiratory infection. Brain magnetic resonance image (MRI) revealed multifocal asymmetrical T2W/fluid attenuated inversion recovery hyperintensities in bilateral subcortical white matter. The white blood cell count in CSF was highly elevated to 313/mm3. However, her symptoms were not controlled by antibiotics but distinctively subsided with high dose steroid pulse therapy. No recurrent neurologic symptom and newly developed lesion in MRI was observed thereafter.
Conclusion: This case suggests that a highly elevated CSF pleocytosis should not exclude the diagnosis of ADEM, which should be considered by clinical course as well as neurologic examination.
|
|
|
KEYWORD
|
|
|
Acute disseminated encephalomyelitis, Infectious meningoencephalitis, Multiple sclerosis
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
 
|