scholarly journals Post-infectious encephalomyelitis in an orthopedic surgeon with motor and cognitive impairment following Campylobacter gastroenteritis with complete recovery

2018 ◽  
Vol 6 (23) ◽  
pp. 22-27
Author(s):  
Christopher Crist ◽  
Nattamol Hosiriluck ◽  
Richard Winn
Keyword(s):  
Central Nervous System ◽  
Campylobacter Jejuni ◽  
Autoimmune Encephalitis ◽  
Complete Recovery ◽  
Acute Disseminated Encephalomyelitis ◽  
Autoimmune Response ◽  
Motor Deficits ◽  
Orthopedic Surgeon ◽  
Demyelinating Disorder ◽  
Post Infectious

Acute disseminated encephalomyelitis, also known as post-infectious encephalomyelitis, is an acute central nervous system demyelinating disorder which typically follows an autoimmune response secondary to a post-viral infection/syndrome. Although uncommon, the outcome can be devastating; mortality is not high but the morbidity may be catastrophic. Survival is anticipated but return to full function of highly motor skilled and cognitive individuals may not be expected. An orthopedic surgeon developed an acute autoimmune encephalitis presumed to be due to Campylobacter jejuni and despite initial significant cognitive and motor deficits was able to recover fully and ultimately return to his specialty surgical occupation.

scholarly journals Acute Disseminated Encephalomyelitis (ADEM): A Demyelinating Disease with Specific Morphological Features

2021 ◽  
pp. 106689692199356
Author(s):  
Fleur Cordier ◽  
Lars Velthof ◽  
David Creytens ◽  
Jo Van Dorpe
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Case ◽  
Demyelinating Disease ◽  
Acute Disseminated Encephalomyelitis ◽  
Demyelinating Diseases ◽  
Demyelinating Disorder ◽  
Immune Mediated ◽  
The Central Nervous System

Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated inflammatory and demyelinating disorder of the central nervous system. Its characteristic perivenular demyelination and inflammation aid in the differential diagnosis with other inflammatory demyelinating diseases. Here, we present a clinical case of ADEM, summarize its histological hallmarks, and discuss pitfalls concerning the most important neuropathological differential diagnoses.

Acute Disseminated Encephalomyelitis

2012 ◽  
Vol 27 (11) ◽  
pp. 1408-1425 ◽  
Author(s):  
Gulay Alper
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Disseminated Encephalomyelitis ◽  
Protein Levels ◽  
Demyelinating Disorder ◽  
Immune Mediated ◽  
Elevated Protein ◽  
Demyelinating Lesions ◽  
Diagnostic Difficulties ◽  
The Central Nervous System

Acute disseminated encephalomyelitis is an immune-mediated inflammatory and demyelinating disorder of the central nervous system, commonly preceded by an infection. It principally involves the white matter tracts of the cerebral hemispheres, brainstem, optic nerves, and spinal cord. Acute disseminated encephalomyelitis mainly affects children. Clinically, patients present with multifocal neurologic abnormalities reflecting the widespread involvement in central nervous system. Cerebrospinal fluid may be normal or may show a mild pleocytosis with or without elevated protein levels. Magnetic resonance image (MRI) shows multiple demyelinating lesions. The diagnosis of acute disseminated encephalomyelitis requires both multifocal involvement and encephalopathy by consensus criteria. Acute disseminated encephalomyelitis typically has a monophasic course with a favorable prognosis. Multiphasic forms have been reported, resulting in diagnostic difficulties in distinguishing these cases from multiple sclerosis. In addition, many inflammatory disorders may have a similar presentation with frequent occurrence of encephalopathy and should be considered in the differential diagnosis of acute disseminated encephalomyelitis.

Demyelinating disorders of the central nervous system

2010 ◽  
pp. 4948-4963
Author(s):  
Siddharthan Chandran ◽  
Alastair Compston
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Acute Disseminated Encephalomyelitis ◽  
Demyelinating Diseases ◽  
Demyelinating Disorder ◽  
System P ◽  
The Central Nervous System ◽  
Demyelinating Disorders ◽  
Brain And Spinal Cord

Clinicians suspect demyelination when episodes reflecting damage to white matter tracts within the central nervous system occur in young adults. The paucity of specific biological markers of discrete demyelinating syndromes places an emphasis on clinical phenotype—temporal and spatial patterns—when classifying demyelinating disorders. The diagnosis of multiple sclerosis, the most common demyelinating disorder, becomes probable when these symptoms and signs recur, involving different parts of the brain and spinal cord. Other important demyelinating diseases include post-infectious neurological disorders (acute disseminated encephalomyelitis), demyelination resulting from metabolic derangements (central pontine myelinosis), and inherited leucodystrophies that may present in children or in adults. Accepting differences in mechanism, presentation, and treatment, two observations can usefully be made when classifying demyelinating disorders. These are the presence or absence of inflammation, and the extent of focal vs. diffuse demyelination. Multiple sclerosis is prototypic for the former, whereas dysmyelinating disorders, such as leucodystrophies are representative of the latter....

Acute Disseminated Encephalomyelitis

2017 ◽  
Author(s):  
Benjamin M. Greenberg ◽  
Allen Desena
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Supportive Care ◽  
Acute Disseminated Encephalomyelitis ◽  
Autoimmune Response ◽  
Inflammatory Disorder ◽  
The Central Nervous System ◽  
The Brain

Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory disorder of the central nervous system (CNS) that can be fatal or lead to long-term disability. Various triggers have been identified in children and adults, which presumably cause an autoimmune response targeting myelin. The resulting inflammation causes demyelination and edema of the brain, spinal cord, and optic nerves. Depending on which portion of the CNS is affected, patients will experience a variety of symptoms including weakness, numbness, ataxia, encephalopathy, and seizures. Treatment is currently focused on reducing the amount of inflammation and supportive care.

scholarly journals Acute Flaccid Myelitis in COVID-19

2020 ◽  
Vol 6 (3) ◽  
pp. 20200098
Author(s):  
Mohamed Abdelhady ◽  
Ahmed Elsotouhy ◽  
Surjith Vattoth
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Case Reports ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
Imaging Findings ◽  
Metabolic Complications ◽  
Acute Flaccid Myelitis ◽  
Post Infectious ◽  
Spinal Cord Imaging

Spinal cord imaging findings in COVID-19 are evolving with the increasing frequency of neurological symptoms among COVID-19 patients. Several mechanisms are postulated to be the cause of central nervous system affection including direct virus neuroinvasive potential, post infectious secondary immunogenic hyperreaction, hypercoagulability, sepsis and possible vasculitis as well as systemic and metabolic complications associated with critical illness. Only a few case reports of spinal cord imaging findings are described in COVID-19, which include transverse myelitis, acute disseminated encephalomyelitis and post-infectious Guillain Barre’ syndrome. We are describing a case of myelitis which, to the best of our knowledge, is the first reported case of myelitis in COVID-19.

scholarly journals Silent Tumefactive Demyelinating Lesions and Radiologically Isolated Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Ozgul Ekmekci ◽  
Cenk Eraslan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Central Nervous System ◽  
Acute Disseminated Encephalomyelitis ◽  
Resonance Imaging ◽  
Demyelinating Disorder ◽  
Radiologically Isolated Syndrome ◽  
Demyelinating Lesions ◽  
The Central Nervous System ◽  
Granulomatous Diseases

Demyelinating lesions larger than 2 cm in diameter, with or without edema, are known as tumefactive demyelinating lesions (TDLs). They constitute a rare inflammatory demyelinating disorder of the central nervous system. TDLs are typically characterized by headaches, cortical symptoms such as aphasia, hemiparesis, hemisensory deficits, seizures, and changes in consciousness. TDLs may occur in patients with or without an established diagnosis of MS or may occur as the initial demyelinating event. They may also be observed during follow-up in patients with MS, neuromyelitis optica, acute disseminated encephalomyelitis, or other autoimmune diseases. Differential diagnosis includes brain tumors, abscess, granulomatous diseases, and vasculitis. In some cases, it may be very difficult to distinguish TDLs from a tumor, such that biopsy might be needed. However, no cases of asymptomatic TDLs have yet been reported in the literature. Hence, in this report, we present a case involving an asymptomatic TDL detected incidentally during magnetic resonance imaging in an 18-year-old man. The patient did not develop any symptoms during the 1-year follow-up period. During follow-up, the patient was diagnosed with a radiologically isolated syndrome. TDLs have not previously been identified as radiologically isolated syndrome. Thus, reporting similar cases in the future will help in further understanding this phenomenon.

scholarly journals Evaluation of demographic, clinical and paraclinical characteristics of children with acute disseminated encephalomyelitis

2020 ◽  
Vol 7 (1) ◽  
pp. e08-e08
Author(s):  
Ahad Ghazavi ◽  
Ezatolah Abbasi ◽  
Hashem Mahmodzadeh ◽  
Tohid Nasiri
Keyword(s):  
Clinical Signs ◽  
Complete Recovery ◽  
Acute Disseminated Encephalomyelitis ◽  
Recent Infection ◽  
Demyelinating Disorder ◽  
Epidemiological Features ◽  
Previous Infection ◽  
History Of ◽  
And Gender ◽  
Common Clinical Finding

Introduction: Acute disseminated encephalomyelitis (ADEM) is an immunologically mediated inflammatory demyelinating disorder that commonly occurs following a viral infection or vaccination. Objectives: This study aimed to evaluate the demographic, clinical and paraclinical characteristics of children with ADEM. Patients and Methods: In a retrospective study, all children who had a definite diagnosis of ADEM were included in the study. Demographic information (including age and gender), epidemiological features (season of onset, history of previous vaccination and previous infection), clinical signs of ADEM, paraclinical features and also clinical outcomes were extracted from patients’ records and entered into a researcher-made checklist. All data were collected, classified and entered into SPSS version 21 for statistical analysis. Results: A total of 27 patients with ADEM were studied out of which, 16 (59.3%) were male and 11 (40.7%) were female. The mean age of patients was 5.21 ± 4.37 years, the youngest of which was three months and the oldest patient had 13 years old. The highest incidence (33.3%) was observed in autumn and 66.7% of patients had a history of recent infection. Electroencephalographic (EEG) findings were abnormal in 55.6% of patients. The most common clinical finding of abnormal EEG was motor disorders (51.8%). Among those who conducted MRI, 71.4% of them had cortical lesions in the brain. In the majority of cases (51.9%), the treatment achieved with intravenous immunoglobulin (IVIG) alone and complete recovery. Conclusion: The ADEM in this region has relatively similar epidemiological features to those studied worldwide and the favorable treatment of our cases has led to a satisfactory percentage of complete clinical recovery.

Central brain herniation secondary to fulminant acute disseminated encephalomyelitis: implications for neurosurgical management

2006 ◽  
Vol 105 (3) ◽  
pp. 472-474 ◽  
Author(s):  
Raymond F. Sekula ◽  
Edward M. Marchan ◽  
Parviz Baghai ◽  
Peter J. Jannetta ◽  
Matthew R. Quigley
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cerebral Edema ◽  
Acute Disseminated Encephalomyelitis ◽  
Small Subset ◽  
Brain Herniation ◽  
Demyelinating Disorder ◽  
Central Brain ◽  
The Central Nervous System ◽  
Neurosurgical Intervention

✓ Acute disseminated encephalomyelitis (ADEM), also known as postinfectious encephalomyelitis, is an immunologically mediated demyelinating disorder affecting the central nervous system that typically occurs after infection or vaccination. The prognosis of ADEM is generally favorable. In a small subset of patients with ADEM, however, fulminant cerebral edema requiring neurosurgical intervention will develop. Few recommendations are available to help the neurosurgeon in dealing with such cases. In this report, the authors present the case of a patient with ADEM in whom central brain herniation developed secondary to medically intractable cerebral edema. The authors review the salient features of the disease and suggest a role for neurosurgeons in cases of fulminant ADEM.

scholarly journals ADEM after ChAdOx1 nCoV-19 vaccine: A case report

2021 ◽  
pp. 135245852110402
Author(s):  
Virginia Rinaldi ◽  
Gianmarco Bellucci ◽  
Andrea Romano ◽  
Alessandro Bozzao ◽  
Marco Salvetti
Keyword(s):  
Magnetic Resonance Imaging ◽  
Central Nervous System ◽  
Demyelinating Disease ◽  
Complete Recovery ◽  
Acute Disseminated Encephalomyelitis ◽  
Resonance Imaging ◽  
Clinical Magnetic Resonance Imaging ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system (CNS), clinically defined by an acute polyfocal neurological syndrome usually with monophasic course. ADEM often occurs after infections, but 5%–10% of cases are preceded by vaccinations. Several cases of ADEM have been described after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, whereas no case has been reported after adenovirus-vectored or mRNA COVID-19 vaccine administration. Here we describe a case of ADEM presenting 2 weeks after receiving the first dose of ChAdOx1 nCoV-19 vaccine. Patient clinical/magnetic resonance imaging (MRI) status spontaneously improved and rapidly resolved with corticosteroids. A 4-month follow-up showed complete recovery and no relapses.

scholarly journals Neurological and mental health consequences of COVID-19: potential implications for well-being and labor force

2021 ◽  
Author(s):  
I B Meier ◽  
C Vieira Ligo Teixeira ◽  
I Tarnanas ◽  
F Mirza ◽  
L Rajendran
Keyword(s):  
Mental Health ◽  
Central Nervous System ◽  
Nervous System ◽  
Cognitive Impairment ◽  
Immune Cell ◽  
Previous History ◽  
Well Being ◽  
Acute Disseminated Encephalomyelitis ◽  
The Central Nervous System ◽  
Neurological Protection

Abstract Recent case studies show that the SARS-CoV-2 infectious disease, COVID-19, is associated with accelerated decline of mental health, in particular, cognition in elderly individuals, but also with neurological and neuropsychiatric illness in young people. Recent studies also show a bidirectional link between COVID-19 and mental health in that people with previous history of psychiatric illness have a higher risk for contracting COVID-19 and that COVID-19 patients display a variety of psychiatric illnesses. Risk factors and the response of the central nervous system to the virus show large overlaps with pathophysiological processes associated with Alzheimer’s disease, delirium, post-operative cognitive dysfunction and acute disseminated encephalomyelitis, all characterized by cognitive impairment. These similarities lead to the hypothesis that the neurological symptoms could arise from neuroinflammation and immune cell dysfunction both in the periphery as well as in the central nervous system and the assumption that long-term consequences of COVID-19 may lead to cognitive impairment in the well-being of the patient and thus in today’s workforce, resulting in large loss of productivity. Therefore, particular attention should be paid to neurological protection during treatment and recovery of COVID-19, while cognitive consequences may require monitoring.

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