León CL, García GRJ, Odales IR, Marrero MP

Language: Spanish
References: 0
Page: 402-410
PDF size: 117.99 Kb.

ABSTRACT

Introduction: acute disseminated encephalomyelitis is a disorder with evidence indicating inflammatory- demyelinizing origin of the central nervous system, and its cause is autoimmune related to infections or vaccines; it is predominant in children, adolescents and young adults in one-phase process, although it is occasionally recurrent. Case presentation: female adolescent with no immunological disorder, who at 13 years of age began showing clinical manifestations of acute disseminated encephalomyelitis. These manifestations evolved into recurrent (multistage) and the brain tissue biopsy revealed slight inflammatory filtrate to lymphocytes, brain edema and finally the polymerase chain reaction was positive to cytomegalovirus. After each event, she just partially recovered from the neurological dysfunction symptoms, which was also evident in her imaging and neurophysiologic studies. Conclusions: in those patients with symptoms and signs of acute encephalomyelitis, either one-stage or recurrent, and progressive deterioration of the neurological condition, there must be suspected possible disseminated encephalomyelitis, so the patient should be studied to confirm this possibility, and it is recommended to take into account association with cytomegalovirus infection, although infrequent and difficult to diagnose, even in patients with no immune response deficiency. The treatment of choice should be intravenous administration of steroid and immunoglobulins; in the event of association with cytomegalovirus, ganciclovir or foscarnet should be prescribed.