Fulminant acute disseminated encephalomyelitis

ABSTRACT

Acute disseminated encephalomyelitis, or post infectious encephalomyelitis is an immunologically mediated demyelinating disorder affecting the central nervous system after infection or vaccination. Young and adolescents are mostly affected with characteristic diffuse neurological signs. Prognosis is generally favorable, however, fulminant acute disseminated encephalomyelitis can be fatal if not diagnosed and treated early. With an increase in intracranial pressure, the treatment of choice is methylprednisolone, followed by immunoglobulin, plasmapheresis or cytotoxic drugs. We present a case of acute disseminated encephalomyelitis in a 17 year male who presented with a sudden onset recurrent generalized tonic-clonic seizures and rapidly become comatose. Magnetic resonance imaging along with other investigations helped in establishing the diagnosis. Treatment resulted in full recovery with uneventful follow up of four years