Abstract
Acute disseminated encephalomyelitis (ADEM) is usually a monophasic disease that may
follow many infections or vaccines. Neuroimaging plays a key role in the differential
diagnosis of ADEM. We reported a female patient with ADEM mimicking a mass lesion
in the pons. On physical examination, the patient was drowsy but there were no signs
of meningeal irritation. Initial magnetic resonance imaging revealed hyperintense
signals on fluid attenuated inversion recovery and T2-weighted sequence over distal
area of bilateral mesencephalon and pons with involvement of cerebellar pedunculus.
The patient was treated intravenous methylprednisolone for 3 days followed by oral
prednisolone for another 7 days. The child remained ataxic for 20 days but recovered
slowly following 4 months. At the 6th months of follow-up neurological findings of
the patient completely recovered, physical examination was normal findings, and control
magnetic resonance imaging scanning was also normal. It should be kept in mind that
early diagnosis and appropriate treatment of the ADEM could prevent serious neurological
sequelae and it is important to make differential diagnosis with other demyelinating
diseases and intracranial mass.
Keywords
Acute disseminated encephalomyelitis - child - cranial mass like lesion
