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Journal of Pediatric Neurology 2018; 16(01): 015-020
DOI: 10.1055/s-0037-1603618
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Acute Disseminated Encephalomyelitis Secondary to Mycoplasma pneumoniae Infection Mimicking Extrapyramidal Symptoms: A Case Report

Chih-Chieh Cheng
1   Department of Pediatrics, Tungs' Taichung MetroHarbor Hospital, Taichung City, Taiwan
,
Hueng-Chuen Fan
1   Department of Pediatrics, Tungs' Taichung MetroHarbor Hospital, Taichung City, Taiwan
,
Ching-Shiang Chi
1   Department of Pediatrics, Tungs' Taichung MetroHarbor Hospital, Taichung City, Taiwan
,
Chuen-Ming Lee
1   Department of Pediatrics, Tungs' Taichung MetroHarbor Hospital, Taichung City, Taiwan
,
Shih-Ting Huang
2   Department of Family Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung City, Taiwan
,
Lang-Lung Yeh
3   Department of Emergency Center, Tungs' Taichung MetroHarbor Hospital, Taichung City, Taiwan
› Author Affiliations
Further Information

Publication History

26 September 2016

24 April 2017

Publication Date:
02 June 2017 (online)

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Abstract

Acute disseminated encephalomyelitis (ADEM) is a rare disease affecting the central nervous system (CNS), and it is difficult to diagnose clinically because of vague prodromal presentations. The therapeutic aim for ADEM is to inhibit the CNS inflammatory reaction as quickly as possible. Treatments may include high-dose corticosteroids and anti-inflammatory and immunosuppressant therapies such as plasmapheresis and high-dose intravenous immunoglobulin. ADEM usually has a good prognosis. Here, we report a rare case of ADEM secondary to Mycoplasma pneumoniae infection mimicking extrapyramidal symptoms.

Keywords

acute disseminated encephalomyelitis - Mycoplasma pneumoniae - extrapyramidal symptoms
 

  • References

  • 1 Gray MP, Gorelick MH. Acute disseminated encephalomyelitis. Pediatr Emerg Care 2016; 32 (06) 395-400
    CrossrefPubMedGoogle Scholar
  • 2 Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: a long-term follow-up study of 84 pediatric patients. Neurology 2002; 59 (08) 1224-1231
    CrossrefPubMedGoogle Scholar
  • 3 Leake JA, Albani S, Kao AS. , et al. Acute disseminated encephalomyelitis in childhood: epidemiologic, clinical and laboratory features. Pediatr Infect Dis J 2004; 23 (08) 756-764
    CrossrefPubMedGoogle Scholar
  • 4 Pavone P, Pettoello-Mantovano M, Le Pira A. , et al. Acute disseminated encephalomyelitis: a long-term prospective study and meta-analysis. Neuropediatrics 2010; 41 (06) 246-255
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Murthy SN, Faden HS, Cohen ME, Bakshi R. Acute disseminated encephalomyelitis in children. Pediatrics 2002; 110 (2 Pt 1): e21 . Doi: 10.3345/kjp.2011.54.6.234
    CrossrefPubMedGoogle Scholar
  • 6 Tenembaum SN. Disseminated encephalomyelitis in children. Clin Neurol Neurosurg 2008; 110 (09) 928-938
    CrossrefPubMedGoogle Scholar
  • 7 Tenembaum S, Chitnis T, Ness J, Hahn JS. ; International Pediatric MS Study Group. Acute disseminated encephalomyelitis. Neurology 2007; 68 (16, suppl 2): S23-S36
    CrossrefPubMedGoogle Scholar
  • 8 Atzori M, Battistella PA, Perini P. , et al. Clinical and diagnostic aspects of multiple sclerosis and acute monophasic encephalomyelitis in pediatric patients: a single centre prospective study. Mult Scler 2009; 15 (03) 363-370
    CrossrefPubMedGoogle Scholar
  • 9 Schwarz S, Mohr A, Knauth M, Wildemann B, Storch-Hagenlocher B. Acute disseminated encephalomyelitis: a follow-up study of 40 adult patients. Neurology 2001; 56 (10) 1313-1318
    CrossrefPubMedGoogle Scholar
  • 10 Erol I, Ozkale Y, Alkan O, Alehan F. Acute disseminated encephalomyelitis in children and adolescents: a single center experience. Pediatr Neurol 2013; 49 (04) 266-273
    CrossrefPubMedGoogle Scholar
  • 11 Jayakrishnan MP, Krishnakumar P. Clinical profile of acute disseminated encephalomyelitis in children. J Pediatr Neurosci 2010; 5 (02) 111-114
    CrossrefPubMedGoogle Scholar
  • 12 Young NP, Weinshenker BG, Parisi JE. , et al. Perivenous demyelination: association with clinically defined acute disseminated encephalomyelitis and comparison with pathologically confirmed multiple sclerosis. Brain 2010; 133 (Pt 2): 333-348
    CrossrefPubMedGoogle Scholar
  • 13 Alper G. Acute disseminated encephalomyelitis. J Child Neurol 2012; 27 (11) 1408-1425
    CrossrefPubMedGoogle Scholar
  • 14 Menge T, Kieseier BC, Nessler S, Hemmer B, Hartung HP, Stüve O. Acute disseminated encephalomyelitis: an acute hit against the brain. Curr Opin Neurol 2007; 20 (03) 247-254
    CrossrefPubMedGoogle Scholar
  • 15 Noorbakhsh F, Johnson RT, Emery D, Power C. Acute disseminated encephalomyelitis: clinical and pathogenesis features. Neurol Clin 2008; 26 (03) 759-780 , ix
    CrossrefPubMedGoogle Scholar
  • 16 Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean MJ. Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children. Neurology 2001; 56 (10) 1308-1312
    CrossrefPubMedGoogle Scholar
  • 17 Krupp LB, Tardieu M, Amato MP. , et al; International Pediatric Multiple Sclerosis Study Group. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult Scler 2013; 19 (10) 1261-1267
    CrossrefPubMedGoogle Scholar
  • 18 Yamamoto K, Takayanagi M, Yoshihara Y. , et al. Acute disseminated encephalomyelitis associated with Mycoplasma pneumoniae infection. Acta Paediatr Jpn 1996; 38 (01) 46-51
    CrossrefPubMedGoogle Scholar
  • 19 Riedel K, Kempf VA, Bechtold A, Klimmer M. Acute disseminated encephalomyelitis (ADEM) due to Mycoplasma pneumoniae infection in an adolescent. Infection 2001; 29 (04) 240-242
    CrossrefPubMedGoogle Scholar
  • 20 Gupta A, Kimber T, Crompton JL, Karagiannis A. Acute disseminated encephalomyelitis secondary to Mycoplasma pneumoniae . Intern Med J 2009; 39 (01) 68-69
    CrossrefPubMedGoogle Scholar
  • 21 Narita M, Matsuzono Y, Togashi T, Kajii N. DNA diagnosis of central nervous system infection by Mycoplasma pneumoniae . Pediatrics 1992; 90 (2 Pt 1): 250-253
    PubMedGoogle Scholar
  • 22 Jacobs E, Bennewitz A, Bredt W. Reaction pattern of human anti-Mycoplasma pneumoniae antibodies in enzyme-linked immunosorbent assays and immunoblotting. J Clin Microbiol 1986; 23 (03) 517-522
    CrossrefPubMedGoogle Scholar
  • 23 Waris ME, Toikka P, Saarinen T. , et al. Diagnosis of Mycoplasma pneumoniae pneumonia in children. J Clin Microbiol 1998; 36 (11) 3155-3159
    CrossrefPubMedGoogle Scholar
  • 24 Moos DD, Hansen DJ. Metoclopramide and extrapyramidal symptoms: a case report. J Perianesth Nurs 2008; 23 (05) 292-299
    CrossrefPubMedGoogle Scholar
  • 25 Honkaniemi J, Dastidar P, Kähärä V, Haapasalo H. Delayed MR imaging changes in acute disseminated encephalomyelitis. Am J Neuroradiol 2001; 22 (06) 1117-1124
    PubMedGoogle Scholar
  • 26 Stüve O, Zamvil SS. Pathogenesis, diagnosis, and treatment of acute disseminated encephalomyelitis. Curr Opin Neurol 1999; 12 (04) 395-401
    CrossrefPubMedGoogle Scholar
  • 27 Khurana DS, Melvin JJ, Kothare SV. , et al. Acute disseminated encephalomyelitis in children: discordant neurologic and neuroimaging abnormalities and response to plasmapheresis. Pediatrics 2005; 116 (02) 431-436
    CrossrefPubMedGoogle Scholar
  • 28 Keegan M, Pineda AA, McClelland RL, Darby CH, Rodriguez M, Weinshenker BG. Plasma exchange for severe attacks of CNS demyelination: predictors of response. Neurology 2002; 58 (01) 143-146
    CrossrefPubMedGoogle Scholar
  • 29 Shahar E, Andraus J, Savitzki D, Pilar G, Zelnik N. Outcome of severe encephalomyelitis in children: effect of high-dose methylprednisolone and immunoglobulins. J Child Neurol 2002; 17 (11) 810-814
    CrossrefPubMedGoogle Scholar
  • 30 Marchioni E, Marinou-Aktipi K, Uggetti C. , et al. Effectiveness of intravenous immunoglobulin treatment in adult patients with steroid-resistant monophasic or recurrent acute disseminated encephalomyelitis. J Neurol 2002; 249 (01) 100-104
    CrossrefPubMedGoogle Scholar
  • 31 Apak RA, Anlar B, Saatci I. A case of relapsing acute disseminated encephalomyelitis with high dose corticosteroid treatment. Brain Dev 1999; 21 (04) 279-282
    CrossrefPubMedGoogle Scholar
  • 32 Kimura S, Nezu A, Ohtsuki N, Kobayashi T, Osaka H, Uehara S. Serial magnetic resonance imaging in children with postinfectious encephalitis. Brain Dev 1996; 18 (06) 461-465
    CrossrefPubMedGoogle Scholar
  • 33 Murthy JM, Yangala R, Meena AK, Jaganmohan Reddy J. Acute disseminated encephalomyelitis: clinical and MRI study from South India. J Neurol Sci 1999; 165 (02) 133-138
    CrossrefPubMedGoogle Scholar
  • 34 Idrissova ZhR, Boldyreva MN, Dekonenko EP. , et al. Acute disseminated encephalomyelitis in children: clinical features and HLA-DR linkage. Eur J Neurol 2003; 10 (05) 537-546
    CrossrefPubMedGoogle Scholar