Acute disseminated encephalomyelitis following varicella‐zoster virus infection: Case report of effective treated both in clinical symptom and neuroimaging

Abstract

Introduction Acute disseminated encephalomyelitis (ADEM) is an idiopathic inflammatory demyelinating disorder of the central nervous system (CNS). Early treatment is the key for neurological recovery. Methods A case of ADEM associated with varicella‐zoster virus infection was presented, in which magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) examinations were included. Results Magnetic resonance imaging of the brain revealed multiple hyperintense lesions at the subcortical level on fluid‐attenuated inversion recovery (FLAIR), and MRI of the spinal cord revealed longitudinally segmented hyperintense lesions at the spinal cord on T2‐weighted images. The patient was treated with methylprednisolone and gancyclovir, and had a favorable recovery. Subsequent MRI of the brain and cervical cord showed the previous abnormal hyperintensities had markedly disappeared. Conclusion A rare case of ADEM with longitudinal segmented hyperintense lesions at the spinal cord on T2‐weighted images was presented. Excellent response to ADEM treatment with high‐dose steroids was reported resulting in a remarkable neurological recovery. A long‐term follow‐up is needed for prognosis.

Do not miss Bickerstaff encephalitis as a complication of SARS-CoV-2 vaccines

“…Missing is a follow-up magnetic resonance imaging to study the evolution of the brainstem lesions. We should know if the corticospinal tract lesion disappeared upon administration of steroids, which would support the diagnosis ADEM [5] .…”

Anti-Myelin Oligodendrocyte Glycoprotein Antibody Positive Acute Disseminated Encephalomyelitis Post-Varicella Zoster Virus Infection

“…Few cases of ADEM associated with VZV have been reported in the literature but none of them were tested for anti-MOG antibody. [ 5 7 ]…”