Fatma AKTAŞ, Resul YILMAZ, Samet ÖZER, Nafia Özlem KAZANCI, Serap BİLGE

Acute Diseminated Encephalomyelitis: A Case Report and Review of Literature

Amaç: Akut disemine ensefalomiyelit (ADEM) otoimmün, monofazik, vaskülitik ve inflamatuvar olmayan yaygın demiyelinizasyon ile seyreden, özellikle de beyin ve spinal kordu etkileyen bir santral sinir sistemi hastalığıdır. ADEM çocukluk çağının nadir görülen bilinç bozukluğu nedenlerinden biridir. 20 yaştan önce hastalığın görülme sıklığı 1.53/100000'dir ve sıklıkla 5-8 yaş arasında görülür. Altta yatan neden tam olarak bilinmese de enfeksiyonlar ve aşılamalar hastalığın ortaya çıkmasında önemli faktörlerdir. Multifokal beyaz cevher lezyonları manyetik rezonans görüntülemede (MR) hastalığın karakteristik özelliğidir. Bizim hastamız da bilinç bulanıklığı ve nöbet sonrası yapılan beyin MR'da serebrumda beyaz cevherde hiperintens lezyonlar saptandı. Hastanın beyin omurilik sıvı incelemesinde hastalığa ait bir özellik saptanmadı. Bu yazıda yüksek doz steroid tedavisi sonrası tam düzelme gösteren, viral üst solunum yolu enfeksiyonu sonrası ADEM gelişen 3 yaşındaki erkek hasta sunulmuştur.

Akut Disemine Ensefalomiyelit; Olgu Sunumu Ve Literatür İncelemesi

Acute disseminated encephalomyelitis (ADEM) is an autoimmune and monophasic central nervous system disease that principally affects brain and spinal cord by causing non-vasculitic inflammatory diffuse demyelination. ADEM is one of the rare causes of impaired consciousness in childhood. Incidence of the disease under the age of 20 is 1.5-3 / 100000 per year and it mostly occurs in children between the ages of 5-8 years. Underlying causes aren't defined clearly yet, however, infections and vaccinations are known as predisposing factors for the disease. Multifocal white matter lesions on magnetic resonance imaging (MRI) are characteristic signs of ADEM. In our case, hyperintense lesions in cerebrum were detected on cranial MRI subsequent to impaired consciousness and convulsion. No specific feature was found in cerebrospinal fluid analysis of the patient. In this paper, we present a three-year-old boy who developed ADEM subsequent to viral upper respiratory tract infection and had full recovery after high dose steroid therapy.

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