MYCOPLASMA-PNEUMONIAE INFECTION ASSOCIATED WITH AN ACUTE BRAIN-STEM SYNDROME

A patient who developed an acute brainstem syndrome following Mycoplas ma pneumoniae respiratory infection is reported. MRI showed changes co nsistent with brainstem demyelination. Clinical features and laborator y investigations support an immune mediated mechanism with no evidence of direction CNS invasion. On the basis of this case and a review of the literature, we postulate two mechanisms for the development of M. pneumoniae associated CNS disease: direct CNS invasion causing meningi tis and an immune-mediated acute disseminated encephalomyelitis (ADEM) . This has obvious therapeutic implications. (C) Munksgaard 1996.