J Korean Acad Rehabil Med.  2008 Aug;32(4):472-475.

Herpetic Multiphasic Disseminated Encephalomyelitis

• Seok H
• Kim JL
• Kim SH
• Lee HJ
• Lee JB

Abstract

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating conditions, which is usually monophasic. Recurrent ADEM and multiphasic disseminated encephalomyelitis (MDEM) is much less characterized entity, and its differentiation from multiple sclerosis (MS) poses a diagnostic challenge. We report a case of multiphasic disseminated encephalomyelitis (MDEM). The patient had two episodes of paraparesis and other neurologic symptoms, which were separated by 2 months. The patient presented with fever, headache, mental change, lower extremity weakness, voiding difficulty as well as focal neurologic deficits, which showed good response on steroid and acyclovir. Brain MRI revealed variable sized, multifocal, subcortical white matter lesions with gray matter involvement, and spine MRI revealed high signal intensity from C3 to T9 spinal cord. The CSF study showed elevated protein count and negative oligoclonal band.

Keyword

Acute disseminated encephalomyelitis; Multiphasic disseminated encephalomyelitis; Herpes Simplex virus

MeSH Terms

Acyclovir
Brain
Encephalomyelitis
Encephalomyelitis, Acute Disseminated
Fever
Headache
Humans
Lower Extremity
Multiple Sclerosis
Neurologic Manifestations
Paraparesis
Simplexvirus
Spinal Cord
Spine
Acyclovir