Document Detail


Non-MS recurrent demyelinating diseases.
MedLine Citation:
PMID:  15177769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The introduction of MRI has shown that the acute, recurrent (R), and multiphasic (M) forms of disseminated encephalomyelitis (DEM) are more common than suspected in adults, and that their MR images are sufficiently characteristic in most instances to make differentiation from multiple sclerosis (MS) possible. In addition, a number of clinical features of DEM are rarely seen in MS: fever, malaise, nausea, vomiting, positional vertigo, convulsions, aphasia, meningism, bilateral optic neuritis, and CSF leukocytosis and elevated protein. CSF oligoclonal bands are usually absent. It is remarkable that confusion between R- and MDEM and MS persists despite the numerous published reports on recurrent DEM dating back 70 years, many illustrating the characteristic MRIs. There are many case reports of DEM erroneously diagnosed as MS, Schilder's, Marburg's, Devic's, and Baló's disease, and, in particular brain tumors. It is probable that acute DEM is occasionally mistaken for a clinically isolated symptom of MS. Possible mechanisms for recurrence include localization at the site of a previous injury to the nervous system, or by the phenomenon of molecular mimicry. The importance of differentiating R- and MDEM from MS is greater today due to the recommendation that immunodulatory treatment be initiated in patients with a clinically isolated syndrome, or when the occurrence of a second clinical episode establishes the diagnosis of MS.
Authors:
Vesna V Brinar
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  106     ISSN:  0303-8467     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-04     Completed Date:  2004-08-26     Revised Date:  2009-10-14    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  197-210     Citation Subset:  IM    
Affiliation:
Department of Neurology, Faculty of Medicine, Neurology Service, REBRO Hospital Centre, Kispaticeva 12, 10.000 Zagreb, Croatia. vesna.brinar@zg.htnet.hr
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents / therapeutic use
Atrophy / pathology
Brain / pathology*
Demyelinating Diseases / pathology*
Diagnosis, Differential
Female
Humans
Immunoglobulin G / therapeutic use
Immunoglobulins, Intravenous / administration & dosage
Injections, Intravenous
Magnetic Resonance Imaging
Male
Methylprednisolone / therapeutic use
Middle Aged
Multiple Sclerosis / complications,  drug therapy,  pathology*
Optic Neuritis / diagnosis
Recurrence
Reflex, Abnormal
Tongue / pathology
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Immunoglobulin G; 0/Immunoglobulins, Intravenous; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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