Alqarni Abdulaziz A, Aljafari Danya A, Alzahrani Faris A, Alharthi Abdulrahman A, Alhubayshi Madihah S
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Research and Development, King Abdullah International Medical Research Center, Jeddah, SAU.
Cureus. 2023 Feb 3;15(2):e34615. doi: 10.7759/cureus.34615. eCollection 2023 Feb.
Acute disseminated encephalomyelitis (ADEM) is a monophasic condition characterized by inflammation of the central nervous system. Besides multiple sclerosis, optic neuropathy, acute transverse myelitis, and neuromyelitis optica spectrum disorder, ADEM is a primary inflammatory demyelinating disorder of the central nervous system. It is estimated that approximately three-quarters of cases of encephalomyelitis occur after an infection or immunization, where the onset of neurological disease is coincident with a febrile event. Here, we report an 80-year-old woman with coronavirus disease pneumonia who developed sudden onset of decreased level of consciousness, focal seizure, and right-side weakness. Magnetic resonance imaging (MRI) of the brain showed a multifocal hemorrhagic lesion with surrounding edema, suggesting ADEM. An electroencephalogram (EEG) revealed moderate generalized encephalopathy. The patient received alternating pulse steroids with plasma exchange for five days. Subsequently, her Glasgow coma scale score continued to decrease, and thus, she required inotropic support until she expired.
急性播散性脑脊髓炎（ADEM）是一种以中枢神经系统炎症为特征的单相疾病。除了多发性硬化症、视神经病变、急性横贯性脊髓炎和视神经脊髓炎谱系障碍外，ADEM是中枢神经系统的一种原发性炎症性脱髓鞘疾病。据估计，约四分之三的脑脊髓炎病例发生在感染或免疫接种后，神经系统疾病的发作与发热事件同时出现。在此，我们报告一名80岁的冠状病毒病肺炎女性患者，她突然出现意识水平下降、局灶性癫痫发作和右侧肢体无力。脑部磁共振成像（MRI）显示多灶性出血性病变伴周围水肿，提示为ADEM。脑电图（EEG）显示中度全身性脑病。患者接受了为期五天的交替脉冲类固醇与血浆置换治疗。随后，她的格拉斯哥昏迷量表评分持续下降，因此，她需要使用血管活性药物支持，直至死亡。
