A 19-year-old previously healthy male presents 2 weeks after an upper respiratory viral illness with acute confusion and generalized seizure. Vital signs: BP 118/76, HR 102, RR 20, Temp 37.8°C, SpO2 98%. He reports bilateral arm weakness but denies focal sensory deficits. CSF analysis reveals elevated protein (68 mg/dL) with mild lymphocytic pleocytosis (45 cells/μL). Brain MRI demonstrates multifocal white matter lesions. Which of the following is the most likely diagnosis?
- A)Subcute sclerosing panencephalitis
- B)Bacterial meningitis
- C)Acute disseminated encephalomyelitisGABARITO
- D)Multiple sclerosis
- E)Herpes simplex encephalitis
Explicação
ADEM is an acute demyelinating disease that typically follows a viral infection or vaccination by 1–4 weeks. It presents with multifocal neurologic symptoms (confusion, seizures, weakness), multifocal white matter lesions on MRI, and CSF pleocytosis. It is mon... Ver explicação completa e trilha adaptativa →