Advertisement

Cerebellar hemorrhage as the primary clinical manifestation of hyperacute disseminated encephalomyelitis: a case report

  • Shaoyang Sun
  • Jing Wang
  • Min Liu
  • Tao Liu
  • Yanqiang WangEmail author
Letter to the Editor
  • 18 Downloads

Introduction

Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory demyelinating encephalopathy with extensive involvement of the white matter. The clinical manifestations include headache, epileptic seizures, ataxia, quadriplegia, mental symptoms, altered consciousness and other multifocal neurological dysfunctions. Acute hemorrhagic leukoencephalitis (AHLE) is a relatively rare inflammatory demyelinating disease of the central nervous system that is considered a hyperacute type of ADEM [1]. There are no clinical reports of hyperacute ADEM in which cerebellar symptoms are the primary manifestation. We report a case of hyperacute ADEM with cerebellar hemorrhage as the primary manifestation.

Case report

A 32 year old Chinese woman underwent surgical treatment for right congenital blepharoptosis. The patient developed dizziness, vertigo and nausea that improved in the supine position by post-operative day (POD) 7. These symptoms gradually worsened and were accompanied with...

Notes

Funding

This research was supported by National Natural Science Foundation of China (No. 81870943) and Shang dong Provincial Nature Fund Joint Special Fund Project (ZR2018LH006).

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest related to the present work.

Ethical standard

The study was approved by the local Ethics Committee of the Affiliated Hospital of Wei fang Medical University.

Informed consent

The patient provided written informed consent for the study participation.

References

  1. 1.
    Behan PO (1978) Post-infectious encephalomyelitis: some aetiological mechanisms. Postgrad Med J 54(637):755–759CrossRefGoogle Scholar
  2. 2.
    Hart MN, Earle KM (1975) Haemorrhagic and perivenous encephalitis: a clinical-pathological review of 38 cases. J Neurol Neurosurg Psychiatry 38(6):585–591CrossRefGoogle Scholar
  3. 3.
    Gibbs WN, Kreidie MA, Kim RC et al (2005) Acute hemorrhagic leukoencephalitis: neuroimaging features and neuropathologic diagnosis. J Comput Assist Tomogr 29(5):689–693CrossRefGoogle Scholar
  4. 4.
    Mader I, Wolff M, Niemann G et al (2004) Acute haemorrhagic encephalomyelitis (AHEM): MRI findings. Neuropediatrics 35(02):143–146CrossRefGoogle Scholar
  5. 5.
    Nabi S, Badshah M, Ahmed S et al (2016) Weston-Hurst syndrome: a rare fulminant form of acute disseminated encephalomyelitis (ADEM). BMJ Case Rep 2016:bcr2016217215Google Scholar
  6. 6.
    Davies NWS, Sharief MK, Howard RS (2006) Infection–associated encephalopathies—their investigation, diagnosis, and treatment. J Neurol 253(7):833–845CrossRefGoogle Scholar
  7. 7.
    Zeid NEA, Burns JD, Wijdicks EF et al (2010) A typical acute hemorrhagic leukoencephalitis (Hurst’s disease) presenting with focal hemorrhagic brainstem lesion. Neurocrit Care 12(1):95–97CrossRefGoogle Scholar
  8. 8.
    Reig RS, Zazo CS, Martín PM et al (2013) Clinical outcome of the hyperacute form of acute disseminated encephalomyelitis. Anal Pediatria 78(4):234–240CrossRefGoogle Scholar
  9. 9.
    Meilof JF, Hijdra A, Vermeulen M (2001) Successful recovery after high-dose intravenous methylprednisolone in acute hemorrhagic leukoencephalitis. J Neurol 248:898–899CrossRefGoogle Scholar

Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  • Shaoyang Sun
    • 1
  • Jing Wang
    • 1
  • Min Liu
    • 1
  • Tao Liu
    • 1
  • Yanqiang Wang
    • 2
    Email author
  1. 1.Department of NeurologyAffiliated Hospital of Qingdao UniversityQingdaoChina
  2. 2.Department of NeurologyThe Affiliated Hospital of Wei Fang Medical UniversityWeifangChina

Personalised recommendations