Affiliations: Department of Pediatric Neurology, Faculty of
Medicine, Cumhuriyet University, Sivas, Turkey | Department of Radiology, Faculty of Medicine,
Cumhuriyet University, Sivas, Turkey | Department of Pediatrics, Faculty of Medicine,
Cumhuriyet University, Sivas, Turkey
Note: [] Correspondence: Dr. Adnan Ayvaz, Cumhuriyet University, Faculty
of Medicine, Department of Pediatric Neurology, 54100 Sivas, Turkey. Tel.: +90
346 2581182; GSM: +90 505 4858078; E-mail: aayvaz@ttmail.com
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
