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.