• Published
    06-03-2024
  • Issue
    Vol: 28 Issue: 01, 2024
PDF

ROLE OF MRI IN ACUTE DISSEMINATEDENCEPHALOMYELITIS

  • Rushabh Raka1*, Ashutosh Patel2, C. Vatsal Akhani3

Keywords: Acute disseminated encephalomyelitis, ADEM, MRI, CNS disorder.

ABSTRACT:-
Background: Acute disseminated encephalomyelitis (ADEM) is indeed an acute demyelinating disorder of the central nervous system (CNS). It is characterized by multifocal white matter involvement, leading to diffuse neurological signs. The disease is characterized by the presence of multifocal lesions in both the brain and spinal cord. It is important to note that ADEM does not involve the invasion of the central nervous system by external pathogens or infectious agents. Instead, it is believed to be immune-mediated, involving inflammation and demyelination triggered by an immune response. Aim: To evaluate role of MRI in acute disseminated encephalomyelitis. Materials and methods: A prospective study of 10 cases which was conducted in the pediatric department in Dhiraj hospital. MRI brain was done on 1.5 Tesla MRI machine. Results: Neuropathologically, ADEM is characterized by perivenular inflammation, which refers to inflammation around the small blood vessels in the affected areas of the CNS, and demyelination, which is the loss of the protective myelin sheath surrounding nerve fibers. These pathological features are distinct from those seen in acute viral encephalitis, where the primary pathology involves the invasion and replication of viruses within the brain tissue. Conclusion: 1. Gender Predominance: ADEM has no female predilection.. 2. Association with Previous Infection: ADEM is more frequently associated with previous infections rather than previous vaccinations. This suggests that certain infections may trigger an immune response leading to the development of ADEM. 3. Neurological Deficits: ADEM typically presents with neurological deficits, which can vary widely depending on the location and extent of demyelination in the central nervous system. 4. Cerebrospinal Fluid (CSF) Findings: Analysis of CSF often reveals raised levels of protein. 5. MRI Findings: Magnetic resonance imaging (MRI) studies commonly show hyperintense lesions on T2-weighted (T2W) and fluid attenuated inversion recovery (FLAIR) sequences. These lesions are indicative of areas of demyelination within the brain and spinal cord. 6. Periventricular Association: ADEM is frequently associated with lesions in the periventricular area of the brain.