Article Figures & Data
Figures
- Figure 1
Patient (1): diffuse patchy asymmetrical bilateral subcortical and deep white matter hyperintense signals in T2 (A) with diffusion restriction (B); follow up MRI after 7 months (C), deep white matter abnormal T2 signal residual lesions; Patient (2), diffuse extensive white matter high T2 signal (D), with no enhancement on T1(E), and remarkable improvement after 6 month(F).
Tables
Variables n (%) Age (y) 9.5+/-6 Gender Female 13 (65) Male 7 (35) Season Autumn 6 (30) Summer 6 (30) Spring 5 (25) Winter 3 (15) Variables n (%) Preceding symptoms URTI 12 (60) Fever 12 (60) Headache 5 (25) Vomiting 4 (20) Neurological deficit Weakness 17 (85) Cerebellar signs 9 (45) Decreased level of consciousness 4 (20) Cranial nerve deficit 2 (10) Seizure 7 (35) CSF analysis abnormalities Pleocytosis 12 (60) High protein 6 (30) Site of the lesion n (%) Cortical and subcortical 17 (85) Deep white matter 17 (85) Periventricular white matter 2 (10) Thalamus 9 (45) Basal ganglia 5 (25) Cerebellum 7 (35) Brainstem 8 (40) Spinal cord 5 (25) Cervical 3 (60) Thoracic 3 (60) Lumbar 1 (20) - Table 4
Summary of all cases with a diagnosis of acute disseminated Encephalomyelitis at King Abdulaziz Medical City from January 1996 to 31st Decemeber 2016.
SNo A/G Pre-inf Clinical presentation MRI brain treatment Outcome 1 17y/M URTI SE, rt HP, ALC Extensive sWM, dWM, CC body MPD, PE Mild Cognitive dysfunction and epilepsy 2 5 y/M URTI, Fever GTCS Bilateral diffuse frontal and parietal sWM & dWM MPD Mild Cognitive dysfunction 3 7y/F URTI, Fever, vomiting Ataxia, ALC, rt CNVI&CNVII palsy, dysartheria C spine, Thalamus Medulla, Pons, Brachium Pontis, cerebellum normal 4 6.5 y/F URTI, Fever, headache Mild quadreparesis Lt more than rt frontal and parietal sWM & dWM. MPD normal 5 11y/F Fever, headache Parapresis & sensory level at T3 Bilateral scattered multiple supratentorial sWM & dWM & T-L spine. MPD, IVIG, normal 6 2y/F URTI Mild quadriparesis Bilateral scattered multiple supratentorial sWM T spine. MPD normal 7 17y/F URTI, headache Ataxia, nystagmus, dysarthria and mild quadriparesis Bilateral scattered multiple supratentorial sWM & dWM, Thalamus, midbrain, pons MPD normal 8 6y/M URTI Paraparesis, sphincter dysfunction Bilateral scattered multiple supratentorial sWM & dWM & Thalamus, C-T spine MPD normal 9 17y/F URTI, Fever, headache Mild quadreparesis ataxia, dysartheria bilateral CNVII palsy, nystagmus Bilateral scattered multiple supratentorial sWM & dWM & C spine, pons, medulla, cerebellum MPD dysarthria, ataxia 10 4.5y/F Fever, Lethargy Paraparesis, Seizure Bilateral scattered multiple supratentorial sWM & dWM, pons, medulla MPD normal 11 11y/M Diarrhea Lt HP Bilateral scattered multiple supratentorial sWM, midbrain, cerebellum, thalamus MPD normal 12 15y/F Ataxia, dysarthria, nystagmus Lt more than rt supratentorial dWM, lt thalamus, cerebellum MPD normal 13 17y/F Fever, headache, vomiting Ataxia, dysarthria, nystagmus Bilateral scattered multiple supratentorial dWM, midbrain, pons, cerebellum Lost Follow up 14 17y/M URTI, Fever, vomiting Ataxia, dysarthria, nystagmus, mild parapresis Bilateral diffuse multiple supratentorial sWM & dWM, Thalamus MPD normal 15 3y/F Pneumonia ALC, parapresis, Myoclonic seizures Bilateral diffuse multiple supratentorial sWM & dWM, thalamus, midbrain and pons. MPD Unable to stand 16 4.5y/F Fever and vomiting Lt HP, ataxia Bilateral diffuse multiple supratentorial sWM & dWM, thalamus, pons, cerebellum MPD normal 17 2y/F Fever, Irritability Spastic quadreparesis, ALC, seziures. Bilateral occipital and parietal sWM & dWM, Thalamus MPD Lost Follow up 18 15y/M URTI Ataxia, dysarthria Bilateral scattered multiple supratentorial dWM, cerebellum MPD normal 19 12y/F URTI, Fever Ataxia, GTCS Bilateral diffuse frontal and parietal sWM & dWM normal 20 6m/M URTI, Fever GTCS Bilateral diffuse frontal and parietal sWM & dWM MPD Lost Follow up SE - Status epilepsy, RT - Right, LT - Left, HP - Hemiparesis, ALC - Altered level of consciousness, sWM - Subcortical white matter, dWM - Deep white matter, CC - Corpus collosum, MPD - Prednisolone, PE - Plasma Exchange, GTCS - Generalized Tonic-clonic seizure, C - Cervical, T- L - Thoracic- Lumbar, y -year, F- female, M - Male, URTI- Upper respiratory tract infections
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