Ohtake Toshiyuki, Hirai Shunsaku
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo.
Intern Med. 2004 Aug;43(8):746-9. doi: 10.2169/internalmedicine.43.746.
We report a patient with recurrent acute meningoencephalitis who had three episodes of headache, fever and unconsciousness; the first episode was at age 6 and the second, at age 7. After a 12-year symptom-free interval, she had a relapse, exhibiting the same symptoms as those in the previous two episodes. Head magnetic resonance imaging also revealed the recurrence of lesions in the basal ganglia and medial portion of the temporal lobe. The occurrences of stereotyped symptoms with meningoencephalitis and the same lesions in the basal ganglia observed in each episode favor the diagnosis of recurrent acute disseminated encephalomyelitis (ADEM) rather than multiple sclerosis or multiphasic disseminated encephalomyelitis. The occurrence of this rare case suggests that ADEM can relapse after a very long symptom-free interval.
我们报告了一名复发性急性脑膜脑炎患者，该患者出现了三次头痛、发热和昏迷发作；第一次发作于6岁，第二次发作于7岁。在12年无症状期后，她复发了，表现出与前两次发作相同的症状。头部磁共振成像还显示基底神经节和颞叶内侧部分的病变复发。每次发作中出现的脑膜脑炎刻板症状以及基底神经节相同病变，支持复发性急性播散性脑脊髓炎（ADEM）的诊断，而非多发性硬化或多相性播散性脑脊髓炎。这一罕见病例的出现表明，ADEM可在很长的无症状期后复发。
