Acute disseminated encephalomyelitis affecting medulla and upper cervical cord--comparison of the clinical signs and MRI findings

Journal: Rinsho Shinkeigaku = Clinical Neurology
Published:
Abstract

Correlation of MRI abnormalities and clinical manifestations was studied in a case of acute disseminated encephalomyelitis. A 54-year-old man developed Brown-Séquard syndrome affecting the right upper cervical cord, bilateral bulbar palsy, right Horner syndrome, and rotatory nystagmus. After the admission, right facial numbness and weakness of left upper and lower limbs were added. He was treated with glucocorticosteroid successfully. Painful tonic seizures of left upper and lower limbs were noted in the convalescence. T1-weighted MRI of the brain and spinal cord revealed low signal intensity areas in the medulla oblongata and right upper cervical cord. T2-weighted images showed a high signal intensity in the same areas. The distribution of MRI abnormalities well corresponded to the clinically expected lesions. The MRI abnormalities gradually decreased and disappeared with his recovery. The MRI abnormalities appeared to reflect edema accompanying the acute inflammatory process. MRI seems to be a very useful test for verifying lesions in the brainstem and spinal cord in a case of acute disseminated encephalomyelitis.

Authors
T Muramoto, J Kira, T Yoshimura, I Goto