Acute disseminated encephalomyelitis differential diagnosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
Differential Diagnosis
| Disease | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings |
|---|---|---|---|---|
| Viral encephalitis [1] | Can occur in any age characterised by fever and occasional prodromal illness | Leukocytosis in blood; T2-weighted MRI shows multiple diffuse hyperintensities overlying the grey matter and white matter of bilateral cerebral cortices, and to a lesser extent the white matter, basal ganglia, brainstem and cerebellum; lymphocytic pleocytosis with elevated protein and normal glucose in CSF. | CSF analysis for viral cultures and serological assays | History of recent travel, animal bites (lyme disease/rabies), contact with childhood exanthema and polio, high-risk occupations and drug abuse; skin rashes (VZV,Measles, Rickettsia). HSV may cause fronto-temporal signs, aphasia, personality changes and focal seizures while myelitis is seen in polio infection. |
| HIV encephalopathy[2] | Waxing and waning pattern of psychomotor retardation, decreased memory, concentration and attention span. Tremor, ataxia, hyperreflexia, hypertonia, progressive decline in MMSE scores[3]. Typical absence of cortical signs and symptoms | Increase in CSF protein, cell count; multiple symmetric, hyperintense, non-enhancing subcortical foci on T2-weighted MRI[4]. | Identification of HIV RNA in CSF | Bowel and/or bladder complaints |
| Multiple sclerosis | ||||
| Antiphospholipid antibody syndrome |
References
- ↑ Kennedy PG (2004). "Viral encephalitis: causes, differential diagnosis, and management". J Neurol Neurosurg Psychiatry. 75 Suppl 1: i10–5. doi:10.1136/jnnp.2003.034280. PMC 1765650. PMID 14978145.
- ↑ "StatPearls". 2022. PMID 32310354 Check
|pmid=value (help). - ↑ Nir TM, Jahanshad N, Busovaca E, Wendelken L, Nicolas K, Thompson PM; et al. (2014). "Mapping white matter integrity in elderly people with HIV". Hum Brain Mapp. 35 (3): 975–92. doi:10.1002/hbm.22228. PMC 3775847. PMID 23362139.
- ↑ Valcour V, Paul R, Chiao S, Wendelken LA, Miller B (2011). "Screening for cognitive impairment in human immunodeficiency virus". Clin Infect Dis. 53 (8): 836–42. doi:10.1093/cid/cir524. PMC 3174098. PMID 21921226.