A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged Adult
Objectives. Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that is often preceded by infection or recent vaccination. Encephalopathy and focal neurological deficits are usually manifest several weeks after a prodromal illness with rapidly progressive neurologic...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2015/601706 |
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| _version_ | 1832564636877062144 |
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| author | Nicole Mahdi Peter A. Abdelmalik Mark Curtis Barak Bar |
| author_facet | Nicole Mahdi Peter A. Abdelmalik Mark Curtis Barak Bar |
| author_sort | Nicole Mahdi |
| collection | DOAJ |
| description | Objectives. Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that is often preceded by infection or recent vaccination. Encephalopathy and focal neurological deficits are usually manifest several weeks after a prodromal illness with rapidly progressive neurologic decline. ADEM is most commonly seen in children and young adults, in which prognosis is favorable, but very few cases have been reported of older adults with ADEM and thus their clinical course is unknown. Methods. Here we present a case of ADEM in a middle-aged adult that recovered well after treatment. Results. A 62-year-old man presented with encephalopathy and rapid neurological decline following a gastrointestinal illness. A brain MRI revealed extensive supratentorial white matter hyperintensities consistent with ADEM and thus he was started on high dose intravenous methylprednisolone. He underwent a brain biopsy showing widespread white matter inflammation secondary to demyelination. At discharge, his neurological exam had significantly improved with continued steroid treatment and four months later, he was able to perform his ADLs. Conclusions. This case of ADEM in a middle-aged adult represents an excellent response to high dose steroid treatment with a remarkable neurological recovery. Thus it behooves one to treat suspected cases of ADEM in an adult patient aggressively, as outcome can be favorable. |
| format | Article |
| id | doaj-art-cd0b29e386924ba9b13a672c55799972 |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-cd0b29e386924ba9b13a672c557999722025-02-03T01:10:34ZengWileyCase Reports in Neurological Medicine2090-66682090-66762015-01-01201510.1155/2015/601706601706A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged AdultNicole Mahdi0Peter A. Abdelmalik1Mark Curtis2Barak Bar3Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USADepartment of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USADepartment of Pathology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USADepartment of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USAObjectives. Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that is often preceded by infection or recent vaccination. Encephalopathy and focal neurological deficits are usually manifest several weeks after a prodromal illness with rapidly progressive neurologic decline. ADEM is most commonly seen in children and young adults, in which prognosis is favorable, but very few cases have been reported of older adults with ADEM and thus their clinical course is unknown. Methods. Here we present a case of ADEM in a middle-aged adult that recovered well after treatment. Results. A 62-year-old man presented with encephalopathy and rapid neurological decline following a gastrointestinal illness. A brain MRI revealed extensive supratentorial white matter hyperintensities consistent with ADEM and thus he was started on high dose intravenous methylprednisolone. He underwent a brain biopsy showing widespread white matter inflammation secondary to demyelination. At discharge, his neurological exam had significantly improved with continued steroid treatment and four months later, he was able to perform his ADLs. Conclusions. This case of ADEM in a middle-aged adult represents an excellent response to high dose steroid treatment with a remarkable neurological recovery. Thus it behooves one to treat suspected cases of ADEM in an adult patient aggressively, as outcome can be favorable.http://dx.doi.org/10.1155/2015/601706 |
| spellingShingle | Nicole Mahdi Peter A. Abdelmalik Mark Curtis Barak Bar A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged Adult Case Reports in Neurological Medicine |
| title | A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged Adult |
| title_full | A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged Adult |
| title_fullStr | A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged Adult |
| title_full_unstemmed | A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged Adult |
| title_short | A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged Adult |
| title_sort | case of acute disseminated encephalomyelitis in a middle aged adult |
| url | http://dx.doi.org/10.1155/2015/601706 |
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