A 7-year-old girl presents with fever (39.2°C), headache, and generalized tonic-clonic seizures. Vital signs show HR 110/min, RR 22/min, BP 105/68 mmHg, SpO2 98% on room air. MRI reveals multifocal white matter lesions in both hemispheres. CSF analysis demonstrates lymphocytic pleocytosis (85 cells/μL) without oligoclonal bands. Serum and CSF measles IgM antibodies are positive. She denies recent immunizations. Which of the following is the most likely diagnosis?
- A)Acute disseminated encephalomyelitisGABARITO
- B)Acute viral encephalitis
- C)Subacute sclerosing panencephalitis
- D)CNS lymphoma
- E)Multiple sclerosis
Explicação
ADEM is a post-infectious demyelinating disease occurring 2-4 weeks after viral infection (measles, varicella, mumps). It presents with acute encephalopathy, seizures, and multifocal white matter lesions. CSF shows pleocytosis without oligoclonal bands. The mo... Ver explicação completa e trilha adaptativa →