Presentación de un paciente con encefalomielitis difusa aguda

La encefalomielitis diseminada aguda es una enfermedad inflamatoria aguda del sistema nervioso central, inmunomediada, que es mas frecuente en la edad pediatrica. Su diagnostico se basa en la clinica, en la confirmacion del proceso desmielinizante agudo a traves de la resonancia magnetica y en la exclusion de otras posibles etiologias de acuerdo con los criterios establecidos.  Se presento una paciente de 17 anos de edad que ingreso al Hospital Pediatrico con este diagnostico, la cual llevo tratamiento con metilprednisolona y vitaminoterapia. Se siguio posteriormente por el Servicio de Neurologia del  Hospital Clinico Quirurgico Lucia Iniguez Landin con tratamiento de esteroides (prednisona), vitaminoterapia y fisioterapia rehabilitatoria, asi como farmacos anticonvulsiovantes. La paciente presento  secuelas motoras y  epilepsia secundaria. La importancia del seguimiento clinico e imagenologico radica en que existen formas menos frecuentes con recaidas o recurrencias. Tambien debe considerarse la posibilidad de que un primer evento desmielinizante, indistinguible de una encefalomielitis diseminada aguda o que constituya el debut de una esclerosis multiple. Palabras clave: encefalomielitis diseminada aguda, secuelas motoras, epilepsia, esclerosis multiple ABSTRACT Acute disseminated encephalomyelitis is an acute inflammatory disease of the central nervous system, immune mediated, which is more common in childhood. Its diagnosis is based on clinical confirmation of acute demyelinating process through the magnetic resonance  and the exclusion of other diagnoses according to the criteria stablished. A -17 year old female patient was described in this paper, who was  admitted at Pediatric Hospital, she was treated with prednisolone and vitamins. She was later assisted at  the  Neurology Service of Lucia Iniguez Landin Surgical Teaching Hospital with steroroids (prednisone), vitamins  and rehabilitation therapy. The patient presented motor sequelae and secondary epilepsy. The importance of clinical and imaging follow-up is that there are ways less frequent relapse or recurrence. It should also be considered a first demyelinating event, indistinguishable from acute disseminated encephalomyelitis or the beginnig of multiple sclerosis. Key words: acute disseminated encephalomyelitis, motor sequelae, epilepsy Multiple sclerosis