Acute Disseminated Encephalomyelitis: A Gray Distinction
Abstract Background Acute disseminated encephalomyelitis (ADEM) is an immune-mediated, inflammatory acquired demyelinating syndrome predominantly affecting the white matter of the central nervous system. Methods We describe the case of a 3 year old boy, whose clinical presentation was suspicious for...
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| Veröffentlicht in: | Pediatric neurology 2017-03, Vol.68, p.64-67 |
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| creator | Abu-Libdeh, Amal, MBBS Goodkin, Howard P., MD, PhD Ramirez-Montealegre, Denia, MD, PhD Brenton, J. Nicholas, MD |
| description | Abstract Background Acute disseminated encephalomyelitis (ADEM) is an immune-mediated, inflammatory acquired demyelinating syndrome predominantly affecting the white matter of the central nervous system. Methods We describe the case of a 3 year old boy, whose clinical presentation was suspicious for ADEM but initial imaging showed abnormalities confined to the deep gray matter (without evidence of white matter involvement) in the brain. His clinical course was fluctuating and repeat imaging obtained one week after presentation demonstrated interval development of characteristic white matter lesions. Results Treatment with adjunctive intravenous immunoglobulin (IVIg) and high-dose corticosteroids resulted in significant clinical improvement. Conclusions This case of ADEM is novel in demonstrating the initial findings of isolated deep gray matter involvement with delayed appearance of white matter abnormalities, suggesting that repeat imaging is indicated in cases that are clinically suspicious for ADEM but lack characteristic imaging findings |
| doi_str_mv | 10.1016/j.pediatrneurol.2016.12.006 |
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Nicholas, MD</creator><creatorcontrib>Abu-Libdeh, Amal, MBBS ; Goodkin, Howard P., MD, PhD ; Ramirez-Montealegre, Denia, MD, PhD ; Brenton, J. Nicholas, MD</creatorcontrib><description>Abstract Background Acute disseminated encephalomyelitis (ADEM) is an immune-mediated, inflammatory acquired demyelinating syndrome predominantly affecting the white matter of the central nervous system. Methods We describe the case of a 3 year old boy, whose clinical presentation was suspicious for ADEM but initial imaging showed abnormalities confined to the deep gray matter (without evidence of white matter involvement) in the brain. His clinical course was fluctuating and repeat imaging obtained one week after presentation demonstrated interval development of characteristic white matter lesions. Results Treatment with adjunctive intravenous immunoglobulin (IVIg) and high-dose corticosteroids resulted in significant clinical improvement. Conclusions This case of ADEM is novel in demonstrating the initial findings of isolated deep gray matter involvement with delayed appearance of white matter abnormalities, suggesting that repeat imaging is indicated in cases that are clinically suspicious for ADEM but lack characteristic imaging findings</description><identifier>ISSN: 0887-8994</identifier><identifier>EISSN: 1873-5150</identifier><identifier>DOI: 10.1016/j.pediatrneurol.2016.12.006</identifier><identifier>PMID: 28173990</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>acute disseminated encephalomyelitis ; ADEM ; autoimmune ; Brain - diagnostic imaging ; Brain - drug effects ; Cervical Cord - diagnostic imaging ; Cervical Cord - drug effects ; Child, Preschool ; Diagnosis, Differential ; Disease Progression ; encephalitis ; Encephalomyelitis, Acute Disseminated - diagnostic imaging ; Encephalomyelitis, Acute Disseminated - physiopathology ; Encephalomyelitis, Acute Disseminated - therapy ; gray matter ; Gray Matter - diagnostic imaging ; Gray Matter - drug effects ; Humans ; Male ; Neurology ; Pediatrics</subject><ispartof>Pediatric neurology, 2017-03, Vol.68, p.64-67</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-b21343763e3a009810726118a519043bbada0e6caf215f853aa5bc45ba7637773</citedby><cites>FETCH-LOGICAL-c438t-b21343763e3a009810726118a519043bbada0e6caf215f853aa5bc45ba7637773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.pediatrneurol.2016.12.006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28173990$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abu-Libdeh, Amal, MBBS</creatorcontrib><creatorcontrib>Goodkin, Howard P., MD, PhD</creatorcontrib><creatorcontrib>Ramirez-Montealegre, Denia, MD, PhD</creatorcontrib><creatorcontrib>Brenton, J. Nicholas, MD</creatorcontrib><title>Acute Disseminated Encephalomyelitis: A Gray Distinction</title><title>Pediatric neurology</title><addtitle>Pediatr Neurol</addtitle><description>Abstract Background Acute disseminated encephalomyelitis (ADEM) is an immune-mediated, inflammatory acquired demyelinating syndrome predominantly affecting the white matter of the central nervous system. Methods We describe the case of a 3 year old boy, whose clinical presentation was suspicious for ADEM but initial imaging showed abnormalities confined to the deep gray matter (without evidence of white matter involvement) in the brain. His clinical course was fluctuating and repeat imaging obtained one week after presentation demonstrated interval development of characteristic white matter lesions. Results Treatment with adjunctive intravenous immunoglobulin (IVIg) and high-dose corticosteroids resulted in significant clinical improvement. Conclusions This case of ADEM is novel in demonstrating the initial findings of isolated deep gray matter involvement with delayed appearance of white matter abnormalities, suggesting that repeat imaging is indicated in cases that are clinically suspicious for ADEM but lack characteristic imaging findings</description><subject>acute disseminated encephalomyelitis</subject><subject>ADEM</subject><subject>autoimmune</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - drug effects</subject><subject>Cervical Cord - diagnostic imaging</subject><subject>Cervical Cord - drug effects</subject><subject>Child, Preschool</subject><subject>Diagnosis, Differential</subject><subject>Disease Progression</subject><subject>encephalitis</subject><subject>Encephalomyelitis, Acute Disseminated - diagnostic imaging</subject><subject>Encephalomyelitis, Acute Disseminated - physiopathology</subject><subject>Encephalomyelitis, Acute Disseminated - therapy</subject><subject>gray matter</subject><subject>Gray Matter - diagnostic imaging</subject><subject>Gray Matter - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Neurology</subject><subject>Pediatrics</subject><issn>0887-8994</issn><issn>1873-5150</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1rFEEQhhuJmDX6F2TBSy4zdnVPfxkQlrhGIeBBPTc9PbWkN_Ox6e4J7L9PDxsFPXkqKJ63inqKkPdAa6AgP-zrA3bB5TjiHKe-ZqVZA6splS_ICrTilQBBz8iKaq0qbUxzTl6ntKeUCsOaV-ScaVDcGLoieuPnjOvPISUcwugyduvt6PFw5_ppOGIfckgf15v1TXTHBcth9DlM4xvycuf6hG-f6wX59WX78_prdfv95tv15rbyDde5ahnwhivJkTtKjQaqmATQToChDW9b1zmK0rsdA7HTgjsnWt-I1pWMUopfkMvT3EOcHmZM2Q4heex7N-I0JwtaSmaYMqKgVyfUxymliDt7iGFw8WiB2kWd3du_1NlFnQVmi7qSfve8aG4H7P5kf7sqwPYEYDn3MWC0yQcsrroQ0WfbTeE_F336Z47vwxi86-_xiGk_zXEsRi3YVAL2x_LF5YkgeZHHJH8C0PWbQQ</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Abu-Libdeh, Amal, MBBS</creator><creator>Goodkin, Howard P., MD, PhD</creator><creator>Ramirez-Montealegre, Denia, MD, PhD</creator><creator>Brenton, J. Nicholas, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Acute Disseminated Encephalomyelitis: A Gray Distinction</title><author>Abu-Libdeh, Amal, MBBS ; Goodkin, Howard P., MD, PhD ; Ramirez-Montealegre, Denia, MD, PhD ; Brenton, J. Nicholas, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-b21343763e3a009810726118a519043bbada0e6caf215f853aa5bc45ba7637773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>acute disseminated encephalomyelitis</topic><topic>ADEM</topic><topic>autoimmune</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - drug effects</topic><topic>Cervical Cord - diagnostic imaging</topic><topic>Cervical Cord - drug effects</topic><topic>Child, Preschool</topic><topic>Diagnosis, Differential</topic><topic>Disease Progression</topic><topic>encephalitis</topic><topic>Encephalomyelitis, Acute Disseminated - diagnostic imaging</topic><topic>Encephalomyelitis, Acute Disseminated - physiopathology</topic><topic>Encephalomyelitis, Acute Disseminated - therapy</topic><topic>gray matter</topic><topic>Gray Matter - diagnostic imaging</topic><topic>Gray Matter - drug effects</topic><topic>Humans</topic><topic>Male</topic><topic>Neurology</topic><topic>Pediatrics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abu-Libdeh, Amal, MBBS</creatorcontrib><creatorcontrib>Goodkin, Howard P., MD, PhD</creatorcontrib><creatorcontrib>Ramirez-Montealegre, Denia, MD, PhD</creatorcontrib><creatorcontrib>Brenton, J. Nicholas, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abu-Libdeh, Amal, MBBS</au><au>Goodkin, Howard P., MD, PhD</au><au>Ramirez-Montealegre, Denia, MD, PhD</au><au>Brenton, J. Nicholas, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute Disseminated Encephalomyelitis: A Gray Distinction</atitle><jtitle>Pediatric neurology</jtitle><addtitle>Pediatr Neurol</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>68</volume><spage>64</spage><epage>67</epage><pages>64-67</pages><issn>0887-8994</issn><eissn>1873-5150</eissn><abstract>Abstract Background Acute disseminated encephalomyelitis (ADEM) is an immune-mediated, inflammatory acquired demyelinating syndrome predominantly affecting the white matter of the central nervous system. Methods We describe the case of a 3 year old boy, whose clinical presentation was suspicious for ADEM but initial imaging showed abnormalities confined to the deep gray matter (without evidence of white matter involvement) in the brain. His clinical course was fluctuating and repeat imaging obtained one week after presentation demonstrated interval development of characteristic white matter lesions. Results Treatment with adjunctive intravenous immunoglobulin (IVIg) and high-dose corticosteroids resulted in significant clinical improvement. Conclusions This case of ADEM is novel in demonstrating the initial findings of isolated deep gray matter involvement with delayed appearance of white matter abnormalities, suggesting that repeat imaging is indicated in cases that are clinically suspicious for ADEM but lack characteristic imaging findings</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28173990</pmid><doi>10.1016/j.pediatrneurol.2016.12.006</doi><tpages>4</tpages></addata></record> |
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| subjects | acute disseminated encephalomyelitis ADEM autoimmune Brain - diagnostic imaging Brain - drug effects Cervical Cord - diagnostic imaging Cervical Cord - drug effects Child, Preschool Diagnosis, Differential Disease Progression encephalitis Encephalomyelitis, Acute Disseminated - diagnostic imaging Encephalomyelitis, Acute Disseminated - physiopathology Encephalomyelitis, Acute Disseminated - therapy gray matter Gray Matter - diagnostic imaging Gray Matter - drug effects Humans Male Neurology Pediatrics |
| title | Acute Disseminated Encephalomyelitis: A Gray Distinction |
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