Abstract
A case of early-onset acute disseminated encephalomyelitis was presented with her brain imaging. Two weeks after a nonspecific upper respiratory infection, a 14-month-old girl developed spastic paraplegia, difficulty in using left upper extremity and mental deterioration with aphasia. Steroid improved her clinical symptoms. However, 9 weeks later, when steroid was almost withdrawn, relapse with meningeal signs appeared. Reinstitution of steroid was started and 8 weeks later when meningeal signs disappeared, rehabilitation by physical therapist was started. Eighteen months later she recovered into normal intelligence and slight gait difficulty walking with left lower extremity weakness. CT showed extensive symmetric low density lesions in bilateral cerebral white matters and they almost resolved 8 months later. MRI showed extensive symmetric high signal lesions in bilateral cerebral white matters which were demonstrable in the sagittal image. Abnormalities in MRI were much improved 4 months later when she began to speak several words again.