Okumura A, Hayakawa M, Watanabe K, Kito M, Negoro T, Kawamura M
Department of Pediatrics, Nagoya University School of Medicine.
No To Hattatsu. 1992 May;24(3):278-82.
Lesions in the thalamus or basal ganglia have rarely been reported in acute disseminated encephalomyelitis (ADEM). We experienced 2 cases of ADEM, in which MRI showed lesions in the thalamus or basal ganglia. Case 1, a 4-year-old boy, had gait disturbance, hyperesthesia and hyperreflexia. MRI (T2 weighted image) showed multiple high intensity areas in the right frontal lobe, bilateral parietal lobes and bilateral thalami. Case 2, a 4-year-old girl, complained of gait disturbance following a febrile episode, and displayed hyperreflexia. Several days later, she had visual disturbance of the left eye. MRI (T2 weighted image) revealed multiple high intensity areas in the dentate nucleus of left cerebellum, left occipital lobe, bilateral caudate nuclei, and the anterior part of bilateral lenticular nuclei. In both cases, CT could not demonstrate these lesions. Both of them were treated with corticosteroid and recovered rapidly. They had no recurrence. MRI is useful in diagnosis and follow-up of ADEM and may reveal lesions other than cerebral or cerebellar white matters.
丘脑或基底神经节病变在急性播散性脑脊髓炎（ADEM）中鲜有报道。我们遇到2例ADEM患者，其MRI显示丘脑或基底神经节有病变。病例1，一名4岁男孩，有步态障碍、感觉过敏和反射亢进。MRI（T2加权像）显示右侧额叶、双侧顶叶和双侧丘脑有多个高强度区域。病例2，一名4岁女孩，发热后出现步态障碍，并表现出反射亢进。几天后，她出现左眼视力障碍。MRI（T2加权像）显示左小脑齿状核、左枕叶、双侧尾状核以及双侧豆状核前部有多个高强度区域。在这两个病例中，CT均未显示这些病变。两人均接受了皮质类固醇治疗，恢复迅速。他们没有复发。MRI对ADEM的诊断和随访有用，可能会显示除脑或小脑白质以外的病变。
