Post-infectious encephalomyelitis

Abstract

The term post-infectious encephalomyelitis (PIEM) is frequently used interchangeably with acute disseminated encephalomyelitis (ADEM), although technically PIEM occurs after a known infection whereas with ADEM there is no antecedent infection. PIEM represents one of the primary demyelinating disorders of the central nervous system, along with multiple sclerosis and Devic's disease. There is no specific diagnostic test for any of these conditions and at onset it may be difficult to differentiate between ADEM and the first attack of multiple sclerosis. However, there are clinical and magnetic resonance imaging features that allow differentiation between PIEM/ADEM and a relapsing disease such as multiple sclerosis. Some patients improve spontaneously; most improve with methylprednisolone. If that fails, plasma exchange or intravenous immunoglobulin may be effective.

Parainfectious Optic Neuritis

“…These results are in agreement with previous studies (1,7,10). These results are in agreement with previous studies (1,7,10).…”

“…This observation has been described in pediatric optic neuritis regardless of etiology (8,10,11). Time elapsed between the febrile illness and the onset of the visual symptoms was shorter in the pediatric group.…”

“…In the adult group, the diagnosis of optic neuritis days to weeks after the presumed systemic infection support the theory that parainfectious optic neuritis is due to an immunologic-inflammatory reaction (1,(5)(6)(7)(8)(9)(10)(11). The rare occurrence of uveitis in these cases also may be related to this reaction.…”

Acute Disseminated Encephalomyelitis: Clinical and Pathogenesis Features

“…Both CT scanning and MRI have been used to diagnose ADEM; however, MRI is much more informative. CT scan of brain can be normal at the onset and start to reveal abnormalities as late as 5 to 14 days after the start of the disease, showing multifocal subcortical lesions in the white matter [116]. Hemorrhage and edema can be detected in CT scans of AHLE cases [116].…”

Acute Demyelinating Encephalomyelitis After Anti-venom Therapy in Russell’s Viper Bite

“…Methylprednisolone 10-30 mg/kg/d (maximum 1 g/day) over 3-5 days followed by a tapered oral prednisolone over 2-6 weeks, is recommended as a standard medical treatment [9]. Other options include the use of anti-inflammatory and immunosuppressive treatments such as intravenous immunoglobulin and plasmapheresis specially when no improvement is seen or the patient continues to deteriorate [10].…”