Summary. Epidemiology. The incidence rate has been estimated at 1 in , , per year. Clinical description. Children younger than 10 years are. Rev Clin Esp ;e – Vol. Num.4 DOI: / Comunicación clínica. Encefalomielitis aguda diseminada tras infección por el. DOI: /S(07) Encefalomielitis aguda diseminada tras sobredosis de cocaína. Acute disseminated encephalomyelitis associated to.
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Grey matter, especially that of the basal gangliais also often involved, albeit to a lesser extent, as is the spinal cord. Typically, ADEM presents in children or adolescents usually younger than 15 years of age. However, cases have been reported in all ages Winter and spring seasonal peaks in the presentation have been observed in some studies, supporting the infectious etiology hypothesis 9.
Encefalomielitis diseminada aguda – Artículos – IntraMed
Unlike many other demyelinating diseases e. ADEM is usually a monophasic illness, although, within the episode, individual lesions may be of varying stages of evolution, with different lesions maturing over a number of weeks 4. ADEM is thought to occur dideminada a cross-reactivity in immunity to viral antigens, triggering a subsequent autoimmune attack on the CNS.
However, multiple sclerosis typically presents confluent sheets of macrophage infiltration mixed with reactive astrocytes in completely demyelinated regions 9.
Appearances vary from small punctate lesions to tumefactive regionswhich have less mass effect than one would expect for their size, distributed in the supratentorial or infratentorial white matter. Lesions are usually bilateral but asymmetrical. The spinal cord may show confluent intramedullary lesions with variable enhancement, but these are only seen in approximately one-third of cases The lesions are usually indistinct encefalomieliitis of low density within the white matter and may demonstrate necefalomielitis enhancement.
Magnetisation transfer may help distinguish ADEM from multiple sclerosis, in that normal-appearing brain on T2-weighted images has normal magnetisation transfer ratio and normal diffusivitywhereas in multiple sclerosis both measurements are significantly decreased 3.
Treatment typically consists of methylprednisolone, with immunoglobulin and cyclophosphamide reserved for patients refractory to steroids 4.
As fever and infection are well-known triggers for multiple encetalomielitis, it is perhaps not surprising that a history of recent infection is identified in clinically isolated syndrome CIS. To quiz yourself on this article, log in to see multiple choice questions.
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J Intern Med [no pubmed citation] 2. Delayed MR imaging changes in acute disseminated encephalomyelitis. Edit article Share article View revision history.
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Case 8 Case 8. Multiple sclerosis Multiple sclerosis. Loading Stack – 0 images remaining.