Acute Disseminated Encephalomyelitis (ADEM)-A Rare Complication of Falciparum Malaria

作者：Rachita Sarangi^*; Satyasundar Mahapatra; Mrutunjaya Dash; Birakishore Rath

来源：Indian Journal of Pediatrics, 2013, 80(6): 499-501.

DOI：10.1007/s12098-012-0814-9

• Acute disseminated encephalomyelitis
• Magnetic resonance images
• Plasmodium falciparum
• Cerebro-spinal fluid

A 4-y-old girl was admitted with fever and altered sensorium. Peripheral blood smear and quantified buffy coat test showed Plasmodium falciparum infection. She received antimalarial therapy and got discharged on seventh day without any neurological deficit. Seven days later she was readmitted with fever and disorientation. Neurological examination revealed coma and decerebration. The deep tendon reflexes were exaggerated and babiniski response was positive in the right lower limb. MRI of brain revealed multifocal asymmetrical T2W/FLAIR hyperintensities in cerebral hemispheres, sub cortical white matter and midbrain. There was minimal patchy enhancement on contrast study. Any feature of grey matter involvement was not observed. The child improved remarkably after the treatment with methyl prednisolone. A follow up MRI after one year showed a complete resolution of demyelinating lesions. Diagnosis of acute disseminated encephalomyelitis (ADEM) as a complication of falciparum malaria was made based on sudden onset of neurological events, MRI findings and prompt response to corticosteroid therapy.

• 出版日期2013-6
• 单位河北医科大学