A case of acute disseminated encephalomyelitis(ADEM) following rubella infection

ABSTRACT

Acute disseminated encepahalomyelitis(ADEM) is acute monophasic infammatory demyelinating disease of the central nervous systems occurring several days to two weeks after viral illness or vaccination. ADEM following rubella infection is very rare. We experienced a case of 24-years old man who developed confusion, nysmgmus, paraparesis, and voiding difficulty three days after the recovery form rubellar infection expressing skin rash and fever. CSF study showed pleocytosis(119cells/mm3), increased titer of [gM and IgG for rubella,, and myelin basic protein, whereas the level of the glucose and protein is normal. MRI of brain, cervical and thoracic spinal cord showed multiple high signa] intensities in the deep white matter of brain, entire cervical and upper thoracic spinal cord. He had been treated with high dose solumedrol intravenously for six days, and then oral prednisolone for ninteen days. Follow-up CSF study after seven days showed normal profiles and MRI after three weeks demonstrated remarkably decreased size of the previous lesions. He showed much improvement of neurologic symptoms except mild voiding difficulty. We report a case diagnosed as ADEM with good prognosis following rubella infection.