Pediatric Demyelinating Diseases of the Central Nervous System and Their Mimics by Emmanuelle Waubant & Timothy E. Lotze

Author:Emmanuelle Waubant & Timothy E. Lotze
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Additional studies included negative serum and CSF aquaporin-4 IgG antibody, negative ANA, and other rheumatological markers. Serum lactate pyruvate and angiotensin-converting enzyme were normal. Infectious work-up for Lyme disease, Bartonella henselae, West Nile virus, Coxsackie A 16, Listeria monocytogenes, influenza A and B viruses, and adenovirus was negative. HSV1 IgM was elevated in the serum consistent with his diagnosis of herpetic gingivostomatitis .

After review of the MRI, ADEM was suspected, and he was treated with methylprednisolone 30 mg/kg/dose IV for 5 days. His examination improved steadily each day, so that by the end of his IV steroid course, he had only minimal left-sided dysmetria. He was discharged on an oral prednisone taper over 6 weeks. Three months after discharge, a repeat brain MRI showed complete resolution of the lesions and no new lesions. His neurological examination at that time was normal.

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