Presentation
Suffering began 10 days ago when presenting adynamia, lethargy, drowsiness, and difficulty walking and sitting. Lumbar puncture was performed with crystalline cerebrospinal fluid "rock water", 10 cells per field, protein 0.18 mg/dl, glucose 63.9 mg/dl. He was given treatment based on acyclovir, dexamethasone, and cefotaxime and sent to the neuropadiatrics service.
Patient Data
Areas of hyperintensity on T2 and FLAIR and hypodensity on T1 are identified affecting the right prefrontal cortex and adjacent subcortical white matter, in addition similar involvement is seen in the pulvinar of the left thalamus, in the region of the amygdalas of the limbic gyrus bilaterally and in the floor of the fourth ventricle towards the region of the dentate nuclei.
Case Discussion
ADEM corresponds to a post-infectious inflammatory disease that must be considered as a differential diagnosis of the various infectious, inflammatory, or demyelinating pathologies that compromise the central nervous system and we must keep it in mind in our clinical practice.
Its course is generally monophasic, but it can present biphasic in some patients. Its clinical manifestations are varied and non-specific, being fundamental to the findings of the MRI in the diagnosis, which confirm the diagnostic suspicion.
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