Presentation
Patient presents with progressive lower extremity weakness and difficulty urinating following recent viral illness.
Patient Data
Extensive patchy hyperintensity on T2/FLAIR within the cortical and subcortical regions as well as the left putamen. There is sparing of the infratentorium. Post contrast of the brain, there is faint patchy enhancement most notable along the parasagittal frontal and parietal lesions. Some of the lesions are hyperintense on DWI with corresponding hyperintensity on ADC, suggestive of T2 shine through.
Within the spine, there is longitudinally extensive hyperintensity on STIR involving the entire cord with associated swelling. There is faint patchy enhancement and sparing of the cauda equina.
Case Discussion
This case demonstrates the classic imaging appearance and patient demographic of acute disseminated encephalomyelitis. The patient's clinical exam and history supported the diagnosis and CSF was markedly elevated with myelin basic protein. Anti-MOG Ab however, was negative in this patient.
Co-Author: Samantha Scott
Unable to process the form. Check for errors and try again.