Advertisement

The spectrum of postinfectious encephalomyelitis

  • Kun-Long Hung
    Correspondence
    Corresponding author. Tel.: +886-2-27082121; fax: 886-2-27074949
    Affiliations
    Department of Pediatrics, Cathay General Hospital, 280, Section 4 Jen-Ai Road, Taipei 106, Taiwan, ROC

    Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan, ROC

    Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan, ROC
    Search for articles by this author
  • Hung-Tsai Liao
    Affiliations
    Department of Pediatrics, Cathay General Hospital, 280, Section 4 Jen-Ai Road, Taipei 106, Taiwan, ROC
    Search for articles by this author
  • Min-Lan Tsai
    Affiliations
    Department of Pediatrics, Cathay General Hospital, 280, Section 4 Jen-Ai Road, Taipei 106, Taiwan, ROC
    Search for articles by this author

      Abstract

      The medical records of 52 consecutive patients diagnosed with postinfectious encephalitis/encephalomyelitis during the period from 1980 to 1998, including 29 males and 23 females, were reviewed. These patients were divided into three groups according to their clinical and neurodiagnostic characteristics: (1) group I: postinfectious encephalitis, 38 patients; (2) group II: acute disseminated encephalomyelitis (ADEM), 13 patients; (3) group III: multiphasic disseminated encephalomyelitis (MDEM), one patient. Fever, headache/vomiting, seizure and disturbance of consciousness were common clinical features in all patients, while pictures of pyramidal, extrapyramidal, brainstem, and spinal cord lesions were more often found in the group II and group III patients than in the group I patients. Magnetic resonance imaging (MRI) revealed abnormal lesions in six (60%) of ten group I patients, but all group II (n=7) and group III (n=1) patients who received MRI study showed abnormal signals in various regions of the brain including the cerebral hemisphere, basal ganglia, brainstem and cerebellum. Patients with ADEM and MDEM had a longer clinical course and more neurological sequelae than group I patients. This study demonstrates the breadth of the clinical spectrum of postinfectious encephalomyelitis. Thorough clinical observations and appropriate neurodiagnostic studies such as MRI are crucial for the diagnosis.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Brain and Development
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Johnson R.T
        Acute encephalitis.
        Clin Infect Dis. 1996; 23: 219-226
        • Lisak R.P
        Immune-mediated parainfectious encephalomyelitis.
        in: McKendall R.R Stroop W.G Handbook of neurovirology. Marcel Dekker, New York1994: 173-186
        • Dyken P.R
        Viral diseases of the nervous system.
        in: Swaiman K.F Pediatric neurology: Principles and practice. C.V. Mosby, St. Louis1994: 669-670
        • Poser C.M
        • Roman G
        • Emery III, S
        Recurrent disseminated vasculomyelinopathy.
        Arch Neurol. 1978; 35: 166-170
        • Kesselring J
        • Miller D.H
        • Robb S.A
        • Kendall B.E
        • Moseley I.F
        • Kingsley D
        • et al.
        Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis.
        Brain. 1990; 113: 291-302
        • Hung K.L
        • Liaw H.T
        • Tsai M.L
        Postinfectious encephalomyelitis: etiologic and diagnostic trends.
        J Child Neurol. 2000; 15: 666-670
        • Tsai M.L
        • Hung K.L
        Multiphasic disseminated encephalomyelitis mimicking multiple sclerosis.
        Brain Dev. 1996; 18: 412-414
        • Johnson R.T
        • Griffin D.E
        • Gendelman H.E
        Postinfectious encephalomyelitis.
        Semin Neurol. 1985; 5: 180-190
        • Caldemeyer K.S
        • Smith R.R
        • Harris T.M
        • Edwards M.K
        MRI in acute disseminated encephalomyelitis.
        Neuroradiology. 1994; 36: 216-220
        • Baum P.A
        • Barkovich A.J
        • Koch T.K
        • Berg B.O
        Deep gray matter involvement in children with acute disseminated encephalomyelitis.
        AJNR. 1994; 15: 1275-1283
        • Tselis A.C
        • Lisak R.P
        Acute disseminated encephalomyelitis and isolated central nervous system demyelinative syndrome.
        Curr Opin Neurol. 1995; 8: 227-229
        • Kimura S
        • Nezu A
        • Ohtsuki N
        • Kobayashi T
        • Osaka H
        • Uehara S
        Serial magnetic resonance imaging in children with postinfectious encephalitis.
        Brain Dev. 1996; 18: 461-465
        • Alcock N.S
        • Hoffman H.L
        Recurrent encephalomyelitis in childhood.
        Arch Dis Child. 1962; 37: 40-44
        • Khan S
        • Yaqub B.A
        • Poser C.M
        • Deeb S.M
        • Bohlega S
        Multiphasic disseminated encephalomyelitis presenting as alternating hemiplegia.
        J Neurol Neurosurg Psychiatry. 1995; 58: 467-470
        • Mostafapour S.P
        • Enzmann D
        • North W
        • Hahn J.S
        Brainstem multiple sclerosis in an 11-year-old child presenting as acute disseminated encephalomyelitis.
        J Child Neurol. 1995; 10: 476-480
        • Poser C.M
        The epidemiology of multiple sclerosis: a general overview.
        Ann Neurol. 1994; 36: S180-S193