Acute Disseminated Encephalomyelitis with Psychotic and Parkinsonian Features: A Case Report
Journal of the Korean Child Neurology Society
;
: 176-183, 2013.
Article
in English
| WPRIM
| ID: wpr-27422
ABSTRACT
Acute disseminated encephalomyelitis (ADEM) is a monophasic immune-mediated demyelination disorder that can arise following infection or immunization. Typical MRI findings show multifocal demyelinating lesions in the CNS. The presenting features include acute encephalopathy with multifocal neurologic signs, and patients often progress to develop delirium and/or coma, but acute psychosis is rare. In our current report, we describe a case of a 14-year-old boy presenting with parkinsonian features (masked face, bradykinesia, resting tremor, slow strides) as well as aggressive behavior and irritability with persecutory delusions that developed 3 days after an upper respiratory tract infection. T2-weighted/FLAIR brain MRI showed increased signal intensity in the hippocampus and basal ganglia including in the caudate nuclei. Cerebrospinal fluid (CSF) enterovirus PCR was positive. After treatment with high-dose methylprednisolone and antipsychotics, he recovered without permanent disabilities, and the initial lesions found on MRI disappeared on follow-up.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Psychotic Disorders
/
Respiratory Tract Infections
/
Antipsychotic Agents
/
Tremor
/
Basal Ganglia
/
Brain
/
Methylprednisolone
/
Magnetic Resonance Imaging
/
Cerebrospinal Fluid
/
Polymerase Chain Reaction
Type of study:
Observational study
/
Prognostic study
Limits:
Adolescent
/
Humans
/
Male
Language:
English
Journal:
Journal of the Korean Child Neurology Society
Year:
2013
Type:
Article
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