Abstract:

Acute disseminated encephalomyelitis (ADEM) is an inflammatory autoimmune demyelinating disease of the central nervous system (CNS). There is no typical clinical presentation of ADEM. The combination of multiple neurological disorders occurring during infections or vaccination should alarm the clinician. We report a case of ADEM in a 37-year-old patient, occurred 2 months after an anti-rabies vaccine shot. The diagnosis was concluded as we had the anti-rabies vaccination 2 months before the onset of symptoms, clinical symptoms (of encephalomyelitis) and the outcome of nuclear magnetic resonance imaging (bilateral and symmetrical signal abnormalities of both capsules and both Putamens, hyposignal in T1, hypersignal in T2 and FLAIR). IV corticosteroid boluses were administered, followed by oral corticosteroid therapy then gradual dose reduction. Clinical evolution was marked by improving of consciousness, disappearance of the motor deficit and the persistence of irreversible blindness. ADEM is a rare and serious condition of the central nervous system. Early management is the key to avoid complications.

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