Härtel Christoph, Schilling Stefan, Gottschalk Stefan, Sperner Jürgen
Department of Pediatrics, University of Lübeck Medical School, Lübeck, Germany.
Eur J Paediatr Neurol. 2002;6(6):327-9. doi: 10.1016/s1090-3798(02)90621-5.
Multiphasic disseminated encephalomyelitis (MDEM) is a rare peculiar diagnosis which is defined as acute demyelinating central nervous system disease with relapses occurring only within 4 weeks of initial manifestation. This report describes the case of a 6-year-old boy with MDEM diagnosed by clinical findings and magnetic resonance imaging. The disease had a biphasic evolution, and with a second course of high-dose corticosteroids a complete recovery without further relapse was obtained during the following 18 months. Serological evidence of streptococcal infection as specific trigger for MDEM was given. Thus this report raises the question whether an additional penicillin prophylaxis could be valuable for prevention of streptococcus-associated MDEM relapses.
多相性播散性脑脊髓炎（MDEM）是一种罕见的特殊诊断疾病，被定义为急性脱髓鞘性中枢神经系统疾病，复发仅发生在初始症状出现后的4周内。本报告描述了一名6岁患有MDEM的男孩病例，该病例通过临床检查结果和磁共振成像得以确诊。该疾病呈双相演变，在接受第二个疗程的大剂量皮质类固醇治疗后，在接下来的18个月内实现了完全康复且未再次复发。给出了链球菌感染作为MDEM特定触发因素的血清学证据。因此，本报告提出了一个问题，即额外的青霉素预防性治疗对于预防与链球菌相关的MDEM复发是否有价值。
