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. 1995 Apr;58(4):467–470. doi: 10.1136/jnnp.58.4.467

Multiphasic disseminated encephalomyelitis presenting as alternating hemiplegia.

S Khan 1, B A Yaqub 1, C M Poser 1, S M al Deeb 1, S Bohlega 1
PMCID: PMC1073436  PMID: 7738557

Abstract

Two cases of alternating hemiparesis are reported, one in a black Sudanese woman, the other in a Saudi man, who had two episodes of alternating hemiparesis separated in time by six and three years respectively. Based on the typical appearance of the MRI and the results of brain biopsy, the diagnosis of multiphasic disseminated encephalomyelitis was made rather than that of multiple sclerosis. This entity is also differentiated from recurrent disseminated encephalomyelitis, where the relapses are symptomatically stereotyped although the appearance of the MRI is similar and in which new lesions do not occur. Because of the unusual appearance of these MRI lesions, brain biopsy is often performed but recognising their relevance should obviate that need.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Biller J., Hingtgen W. L., Adams H. P., Jr, Smoker W. R., Godersky J. C., Toffol G. J. Cervicocephalic arterial dissections. A ten-year experience. Arch Neurol. 1986 Dec;43(12):1234–1238. doi: 10.1001/archneur.1986.00520120019010. [DOI] [PubMed] [Google Scholar]
  2. Boulloche J., Parain D., Mallet E., Tron P. Postinfectious encephalitis with multifocal white matter lesions. Neuropediatrics. 1989 Aug;20(3):173–175. doi: 10.1055/s-2008-1071286. [DOI] [PubMed] [Google Scholar]
  3. Cowan J., Ormerod I. E., Rudge P. Hemiparetic multiple sclerosis. J Neurol Neurosurg Psychiatry. 1990 Aug;53(8):675–680. doi: 10.1136/jnnp.53.8.675. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dun V., Bale J. F., Jr, Zimmerman R. A., Perdue Z., Bell W. E. MRI in children with postinfectious disseminated encephalomyelitis. Magn Reson Imaging. 1986;4(1):25–32. doi: 10.1016/0730-725x(86)91086-6. [DOI] [PubMed] [Google Scholar]
  5. Epperson L. W., Whitaker J. N., Kapila A. Cranial MRI in acute disseminated encephalomyelitis. Neurology. 1988 Feb;38(2):332–333. doi: 10.1212/wnl.38.2.332. [DOI] [PubMed] [Google Scholar]
  6. Fazekas F., Offenbacher H., Fuchs S., Schmidt R., Niederkorn K., Horner S., Lechner H. Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis. Neurology. 1988 Dec;38(12):1822–1825. doi: 10.1212/wnl.38.12.1822. [DOI] [PubMed] [Google Scholar]
  7. Kesselring J., Miller D. H., Robb S. A., Kendall B. E., Moseley I. F., Kingsley D., du Boulay E. P., McDonald W. I. Acute disseminated encephalomyelitis. MRI findings and the distinction from multiple sclerosis. Brain. 1990 Apr;113(Pt 2):291–302. doi: 10.1093/brain/113.2.291. [DOI] [PubMed] [Google Scholar]
  8. Poser C. M. Magnetic resonance imaging in asymptomatic disseminated vasculomyelinopathy. J Neurol Sci. 1989 Dec;94(1-3):69–77. doi: 10.1016/0022-510x(89)90218-9. [DOI] [PubMed] [Google Scholar]
  9. Poser C. M., Román G., Emery E. S., 3rd Recurrent disseminated vasculomyelinopathy. Arch Neurol. 1978 Mar;35(3):166–170. doi: 10.1001/archneur.1978.00500270048010. [DOI] [PubMed] [Google Scholar]
  10. Rodriguez M., Scheithauer B. W., Forbes G., Kelly P. J. Oligodendrocyte injury is an early event in lesions of multiple sclerosis. Mayo Clin Proc. 1993 Jul;68(7):627–636. doi: 10.1016/s0025-6196(12)60597-7. [DOI] [PubMed] [Google Scholar]
  11. Shoji H., Kusuhara T., Honda Y., Hino H., Kojima K., Abe T., Watanabe M. Relapsing acute disseminated encephalomyelitis associated with chronic Epstein-Barr virus infection: MRI findings. Neuroradiology. 1992;34(4):340–342. doi: 10.1007/BF00588198. [DOI] [PubMed] [Google Scholar]
  12. Yahr M. D., Lobo-Antunes J. Relapsing encephalomyelitis following the use of influenza vaccine. Arch Neurol. 1972 Aug;27(2):182–183. doi: 10.1001/archneur.1972.00490140086012. [DOI] [PubMed] [Google Scholar]
  13. Yaqub B. A., Daif A. K. Multiple sclerosis in Saudi Arabia. Neurology. 1988 Apr;38(4):621–623. doi: 10.1212/wnl.38.4.621. [DOI] [PubMed] [Google Scholar]
  14. al Deeb S. M., Yaqub B. A., Sharif H. S., Phadke J. G. Neurobrucellosis: clinical characteristics, diagnosis, and outcome. Neurology. 1989 Apr;39(4):498–501. doi: 10.1212/wnl.39.4.498. [DOI] [PubMed] [Google Scholar]

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