Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Severe Depression as an Initial Symptom in an Elderly Patient with Acute Disseminated Encephalomyelitis
Masayuki MATSUDAJun MIKIKen-ichi TABATAShu-ichi IKEDA
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2001 Volume 40 Issue 11 Pages 1149-1153


We report a 63-year-old man with acute disseminated encephalomyelitis (ADEM), initially showing depression for one and a half months but subsequently meningoencephalitis followed by acute-onset myelopathy. Neuroradiological examinations of the brain demonstrated no focal lesion causative for his depression, while cerebrospinal fluid revealed elevated levels of inflammatory cytokines in parallel with disease activity. Because depression is usually a rare initial symptom for patients with ADEM, an increased production of inflammatory cytokines in the central nervous system as well as age-related alterations of immune response might have played an important role in the development of depression in this elderly patient.
(Internal Medicine 40: 1149-1153, 2001)

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