MRI in children with postinfectious disseminated encephalomyelitis.

Acute disseminated encephalomyelitis, an inflammatory and demyelinating disorder of central nervous system white matter, typically occurs following childhood viral infections. Although CT may demonstrate abnormalities, many children have normal CT studies in spite of widespread neurologic abnormalities. We report a series of five patients with the typical clinical presentation of disseminated encephalomyelitis who were studied using magnetic resonance imaging (MRI). In each case the children presented with progressive subacute neurologic abnormalities including headache, diplopia, ataxia, hemiparesis, seizures, dysarthria, and/or coma. CT was nondiagnostic. MRI clearly demonstrated multifocal white matter lesions of the cerebrum, brainstem, and cerebellum which corresponded to clinical signs. The patients improved dramatically with corticosteroid therapy. MRI showed progressive resolution of multifocal lesions in conjunction with clinical improvement.

Magnetic resonance imaging in childhood disseminated encephalomyelitis.

We report the magnetic resonance imaging features in two children with post-infectious disseminated encephalomyelitis. Magnetic resonance imaging dramatically demonstrated multiple white matter lesions in both children and resolution of lesions in conjunction with clinical recovery. These cases indicate that magnetic resonance imaging has considerable diagnostic utility in disseminated encephalomyelitis of childhood.

Bilateral focal cortical atrophy and chronic ergotamine abuse.

A 67-year-old patient took 5 mg of ergotamine daily for 18 months. His headaches and dysphoria were greatly improved by stopping this drug. Brain imaging by CT and magnetic resonance techniques showed numerous atrophic lesions that may represent infarcts due to occlusion of superficial cortical vessels.