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Academia Mexicana de Neurología, A.C.

2010, Number 4

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Rev Mex Neuroci 2010; 11 (4)

Dilemma in differential diagnosis in demyelinating lesions

Vera UR, Bourlon CR, Ojeda LC, Martínez BM, Mora AT, Sánchez RP, Gunther MG, Kramis HM, Conde ER

Language: Spanish
References: 11
Page: 306-310
PDF size: 204.16 Kb.


ABSTRACT

Among the differential diagnosis of demyelinating lesions the main cause to consider by imaging is a multiple sclerosis related autoimmune process. Between the least frequent entities we have acute disseminated encephalomyelitis (EMDA) a demyelinating disease rare in adults, usually secondary to an infectious process. We describe the case of a 21 year old woman with childhood postvaccinal encephalitis, intermittent migraine-like headache since 11 years old and demyelinating lesions in paraventricular supratentorial white substance. Laboratory analysis was performed to discard the most frequent causes of this sort of manifestations, correlating the magnetic resonance findings with residual postvaccinal EMDA changes. The clinical and imagenological EMDA characteristics are reviewed as is the differential diagnosis of this entity in the context of a patient with demyelinating lesions.


REFERENCES

  1. Lublin FD. Clinical features and diagnosis of multiple sclerosis. Neurol Clin 2005; 23(1): 1-15.

  2. Tenembaum S, Chitnis T, Ness J, Hahn S. Acute disseminated encephalomyelitis. Neurology 2007; 68(Suppl. 2): S23-S36.

  3. Rolak LA, Fleming JO. The differential diagnosis of multiple sclerosis. Neurologist 2007; 13: 57-72.

  4. Dezmalj-Grbelja L, Coviæ-Negovetiæ R, Demarin V. Differential diagnosis and diagnostic algorithm of demyelinating diseases. Act Clin Croat 2009; 48(3): 345-8.

  5. Stonehouse M, Gupte G, Wassmer E, Whitehouse WP. Acute disseminated encephalomyelitis: recognition in the hands of general pediatricians. Arch Dis Child 2003; 88: 122.

  6. Lukes SA, Norman D. Computed tomography in acute disseminated encephalomyelitis. Ann Neurol 1983; 13: 567-72.

  7. Noorbakhsh F, Johnson RT, Emery D, Power D. Acute disseminated encephalomyelitis: Clinical and pathogenesis features. Neurol Clin 2008; 26: 759-80.

  8. Atlas SW, Grossman RI, Goldberg HI, et al. MR diagnosis of acute disseminated encephalomyelitis. J Comput Assist Tomogr 1986; 10: 798-801.

  9. Caldemeyer KS, Smith RR, Harris TM, Edwards MK. MRI in acute disseminated encephalomyelitis. Neuroradiology 1994; 36: 216-20.

  10. Honkaniemi J, Dastidar P, Kahar V, et al. Delayed MR imaging changes in acute disseminated encephalomyelitis. Am J Neuroradiol 2001; 22: 1117-24.

  11. Callen DJA, Shroff MM, Branson HM, et al. Role of MRI in the differentiation of ADEM from MS in children. Neurology 2009; 72: 968-973.




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