Journal of the Korean Academy of Rehabilitation Medicine  2008;32(4):472-475

Herpetic Multiphasic Disseminated Encephalomyelitis.

Hyun SEOK 1 ; Jun Lae KIM ; Sang Hyun KIM ; Hyuk Jin LEE ; Jang Bok LEE

Affiliations

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Keywords

Acute disseminated encephalomyelitis; Multiphasic disseminated encephalomyelitis; Herpes Simplex virus

Country

Republic of Korea

Language

Korean

Abstract

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating conditions, which is usually monophasic. Recurrent ADEM and multiphasic disseminated encephalomyelitis (MDEM) is much less characterized entity, and its differentiation from multiple sclerosis (MS) poses a diagnostic challenge. We report a case of multiphasic disseminated encephalomyelitis (MDEM). The patient had two episodes of paraparesis and other neurologic symptoms, which were separated by 2 months. The patient presented with fever, headache, mental change, lower extremity weakness, voiding difficulty as well as focal neurologic deficits, which showed good response on steroid and acyclovir. Brain MRI revealed variable sized, multifocal, subcortical white matter lesions with gray matter involvement, and spine MRI revealed high signal intensity from C3 to T9 spinal cord. The CSF study showed elevated protein count and negative oligoclonal band.