A 26-year-old woman presents with diplopia, dysarthria, and dysdiadochokinesia one week after a viral illness. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98%. Brain MRI demonstrates multiple T2 hyperintense lesions in the brainstem, corpus callosum, and periventricular white matter with contrast enhancement. CSF analysis reveals oligoclonal bands and elevated IgG index. No fever currently. Which diagnosis best explains these findings?
- A)Acute disseminated encephalomyelitisGABARITO
- B)Tumefactive demyelination
- C)Multiple sclerosis
- D)Viral encephalitis
- E)Posterior reversible encephalopathy syndrome
Explicação
ADEM is a monophasic demyelinating disease that typically follows a viral infection by 1-4 weeks. The acute presentation with brainstem signs (diplopia, dysarthria), cerebellar signs (dysdiadochokinesia), multifocal white matter lesions, and oligoclonal bands ... Ver explicação completa e trilha adaptativa →