ABSTRACT

Acute disseminated encephalomyelitis (ADEM), also known as postinfectious encephalomyelitis, is a demyelinating disease of the central nervous system. It is an uncommon illness. Etiology of the disease was thought to be related with the vaccination as well as some viruses, bacteria and other infectious agents.

A-9-year-old male patient was admitted with headache, fever, confusion, weakness, and inability to urinate for two days of duration. His physical examination revealed neck stiffness and loss of strength in the lower extremities. Cerebrospinal fluid (CSF) examination was consistent with aseptic meningitis. We detected uncertain bordered hyperintensed lesions in right posterior corona radiata and left side of cerebelleum in cranial MRI T2 and FLAIR sequences. This case was diagnosed as ADEM in correlation with the clinical and MRI findings. The patient was treated by 30 mg/kg intravenous methylprednisolon (MP) for 3 days followed by 2 mg/kg/day MP for 4 weeks. The extremity muscle weakness was recovered completely in the first week.

In conclusion; we should not ignore ADEM in meningitis patients with extremity muscle weakness and meningeal inflammation findings in cerebrospinal fluid.