The spectrum of postinfectious encephalomyelitis

The medical records of 52 consecutive patients diagnosed with postinfectiou s encephalitis/encephalomyelitis during the period from 1980 to 1998, inclu ding 29 males and 23 females, were reviewed. These patients were divided in to three groups according to their clinical and neurodiagnostic characteris tics: (1) group I: postinfectious encephalitis, 38 patients; (2) group II: acute disseminated encephalomyelitis (ADEM), 13 patients; (3) group III: mu ltiphasic disseminated encephalomyelitis (MDEM), one patient. Fever, headac he/vomiting, seizure and disturbance of consciousness were common clinical features in all patients, while pictures of pyramidal, extrapyramidal, brai nstem, and spinal cord lesions were more often found in the group II and gr oup III patients than in the group I patients. Magnetic resonance imaging ( MRI) revealed abnormal lesions in six (60%) of ten group I patients, but al l group II (n = 7) and group III (n = 1) patients who received MRI study sh owed abnormal signals in various regions of the brain including the cerebra l hemisphere, basal ganglia, brainstem and cerebellum. Patients with ADEM a nd MDEM had a longer clinical course and more neurological sequelae than gr oup I patients. This study demonstrates the breadth of the clinical spectru m of postinfectious encephalomyelitis. Thorough clinical observations and a ppropriate neurodiagnostic studies such as MRI are crucial for the diagnosi s. (C) 2001 Elsevier Science B.V. All rights reserved.