"Stripped wires" : a case of acute disseminated encephalitis

Publication Date

2016

Document Type

Research

Abstract

This is the case of 1 13-year-old female who initially presented with bilateral knee pain. Said symptom was preceded by fever, stiff neck and vomiting. Knee pain became progressive causing difficulty in ambulating hence consult was done. Patient was initially managed as systematic viral illness while also considering a rheumatic cause. Patient was worked up which only revealed hypocalcemia. Calcium deficit was addressed and she was empirically treat with an antibiotic. She was given pain medication as needed until 2nd hospital day when she experienced sudden onset of bilateral lower extremity weakness. This was associated with decreased sensation of both lower extremities. Patient was referred to a neurologist who considered a demyelinating disease. Further work up was done wherein cranial MRI revealed white matte plaques and EMG-NCV revealed demyelination of motor fibers of the lower extremities. The diagnosis of Acute Disseminated Encephalomyelitis was conferred. Patient was given Methylprednisolone Pulse therapy which eventually offered resolution of symptoms.

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