Download PDF
CC BY-NC-ND 4.0 · Avicenna J Med 2017; 07(02): 71-74
DOI: 10.4103/ajm.AJM_91_16
CASE REPORT

Isolated palatal weakness without optic neuritis as the presenting manifestation of multiple sclerosis and its diagnostic dilemma with acute disseminated encephalomyelitis in a young boy

Virti D Shah
Department of Neurology, Sir Ganga Ram Hospital, New Delhi, India
,
Sumeet Prakash Mirgh
Department of Hematology, All Institute of Medical Sciences, New Delhi, India
,
Nirmal Surya
Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

We present a case of a young boy who at initial presentation was diagnosed as acute disseminated encephalomyelitis (ADEM) but subsequently on follow-up was diagnosed as multiple sclerosis (MS). Differentiating ADEM from MS in their first presentation can be tricky as the features may not be typical of anyone. The importance lies in the close follow-up of these patients.

Keywords

Acute disseminated encephalomyelitis - magnetic resonance imaging - multiple sclerosis - steroids


Publication History

Article published online:
09 August 2021

© 2017. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Alper G, Heyman R, Wang L. Multiple sclerosis and acute disseminated encephalomyelitis diagnosed in children after long-term follow-up: Comparison of presenting features. Dev Med Child Neurol 2009;51:480-6.
  • 2 Dale RC, Branson JA. Acute disseminated encephalomyelitis or multiple sclerosis: Can the initial presentation help in establishing a correct diagnosis? Arch Dis Child 2005;90:636-9.
  • 3 Dale RC, de Sousa C, Chong WK, Cox TC, Harding B, Neville BG. Acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis and multiple sclerosis in children. Brain 2000;123:2407-22.
  • 4 Schwarz S, Mohr A, Knauth M, Wildemann B, Storch-Hagenlocher B. Acute disseminated encephalomyelitis: A follow-up study of 40 adult patients. Neurology 2001;56:1313-8.
  • 5 Cohen O, Steiner-Birmanns B, Biran I, Abramsky O, Honigman S, Steiner I. Recurrence of acute disseminated encephalomyelitis at the previously affected brain site. Arch Neurol 2001;58:797-80.
  • 6 Dekate PS. Acquired demyelinating disorders of central nervous system. Indian J Child Health 2014;1:128-35.
  • 7 Gulati S, Chakrabarty B, Kumar A, Jain P, Patel H, Saini L. Acquired demyelinating disorders of central nervous system: A pediatric cohort. Ann Indian Acad Neurol 2015;18 Suppl 1:S48-55.
  • 8 Gargouri L, Safi F, Fourati H, Kmiha S, Turki F, Zidi F, et al. Early-onset of multiple sclerosis in a 5-year-old girl. Arch Pediatr 2014;21:291-5.