3 research outputs found
Magnetic resonance imaging and clinical features in adults with monophasic demyelinating diseases: acute disseminated encephalomyelitis or a variant of multiple sclerosis?
Acute disseminated encephalomyelitis (ADEM) is a widespread monophasic inflamatory disease affecting the central nervous system, that usually follows an infection or vaccination. In this study, we present an analysis of magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) and clinical aspects in four patients with clinical diagnosis of ADEM. The presence of MRI demyelinating lesions was crucial, but not in itself sufficient for definitive diagnosis. Clinical and MRI follow up, in order to exclude new lesions and to reevaluate the former ones, as well as CSF, were important for the differential diagnosis with other demyelinating diseases, particularly multiple sclerosis. In addition, we have shown that early treatment with methylprednisolone after the initial symptoms was effective for improving clinical manifestations as well as for reducing MRI lesions.A encefalomielite aguda disseminada (ADEM) Ă© doença monofásica inflamatĂłria difusa do sistema nervoso central, que geralmente ocorre apĂłs infecção ou vacinação. Neste estudo, apresentamos a análise da ressonância magnĂ©tica (RM), lĂquor e aspectos clĂnicos de quatro pacientes com diagnĂłstico presuntivo inicial de ADEM. O achado de lesões desmielinizantes na RM foi importante, mas nĂŁo por si sĂł suficiente para o diagnĂłstico definitivo. O seguimento clĂnico e realização de RM de controle, para excluir o aparecimento de novas lesões e reavaliar as anteriores, assim como as análises liquĂłricas, foram importantes para o diagnĂłstico diferencial com outras doenças desmielinizantes, particularmente a esclerose mĂşltipla. AlĂ©m disso, mostramos que a introdução precoce de metilprednisolona foi eficaz tanto para a melhora do quadro clĂnico quanto para redução ou desaparecimento das lesões na RM.85385