A 7-year-old boy presents with fever (39.2°C), headache, confusion, and multifocal neurologic deficits 10 days after recovery from viral upper respiratory infection. Vital signs show HR 102/min, RR 22/min, BP 108/70 mmHg, SpO2 98% on room air. CSF analysis reveals elevated protein (62 mg/dL) and mild lymphocytic pleocytosis. MRI demonstrates widespread bilateral inflammatory demyelinating white matter lesions. No focal hemorrhage noted on imaging. Which of the following is the most likely diagnosis?
- A)Multiple sclerosis
- B)Progressive multifocal leukoencephalopathy
- C)Acute disseminated encephalomyelitisGABARITO
- D)Central pontine myelinolysis
- E)Guillain Barré syndrome
Explicação
A monophasic demyelinating illness in a child following infection with encephalopathy and multifocal white matter lesions is typical of acute disseminated encephalomyelitis. Unlike multiple sclerosis, ADEM usually presents as a single inflammatory episode. Ver explicação completa e trilha adaptativa →