A Case of ADEM Mimicking Cerebral Adrenoleukodystrophy Based on Supratentorial MRI Findings Supratentorial MRG Bulguları Serebral Adrenolökodistrofiye Benzeyen ADEM Olgusu

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating disease of the central nervous system. The disease has a typical onset with sudden neurological symptoms days or weeks after a viral infection or immunization. Measels, rubella, mumps and varicella have been blamed most frequently among viral agents and rabies, diphteria, tetanus, measles, influenza and hepatitis B vaccines have been blamed most frequently among vaccines. It occurs most commonly after mycoplasma infection among bacterial infections. The main pathological findings are perivascular inflammation, edema and demyelinization in white matter (1). The clinical and characteristic magnetic resonance imaging (MRI) findings were identified by the International Pediatric Multiple Sclerosis (MS) Working Group (2). Accordingly, the major clinical characteristics include encephalopathy and polysymptomatic neurological findings and acute or subacute onset demyelinating disease. On MRI, bilateral, asymmetrical, multifocal lesions with a size of larger than 1-2 cm are observed in the supratentorial or infratentorial white matter. Grey matter and especially basal ganglia and thalamus may also be involved. ABSTRACT