Abstract
A 9-year-old boy presented with a subacute history of optic neuritis followed by brainstem involvement, with fever and a lymphocytic pleocytosis in the cerebrospinal fluid. Gadolinium-enhancing ring lesions were demonstrate in the white matter of the cerebrum, brainstem and cerebellum on day 17 of the illness, all appearing simultaneously as part of a monophasic illness. A parietal lesion exerted mass effect. Needling and biopsy yielded no evidence of a pyogenic lesion, tumour or tuberculosis and showed vasculitis. There was insufficient material for myelin staining. Dexamethasone therapy lead to rapid improvement of the radiological lesions: MRI and CT on day 34 of the illness showed complete clearing of the lesions except for residual abnormality at the biopsy site.
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van der Meyden, C.H., de Villiers, J.F.K., Middlecote, B.D. et al. Gadolinium ring enhancement and mass effect in acute disseminated encephalomyelitis. Neuroradiology 36, 221–223 (1994). https://doi.org/10.1007/BF00588135
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DOI: https://doi.org/10.1007/BF00588135