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MR image (FLAIR) showing hyper-intense lesions involving bilateral middle cerebellar peduncles
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Figure 1: MR image (FLAIR) showing hyper-intense lesions involving bilateral middle cerebellar peduncles

Mentions: Routine blood and urine examination was normal. CSF study was also normal. EEG showed frontal beta dominance and mild slowing of the background activity. MRI of brain showed hyperintense signals in T2 and FLAIR sequences involving bilateral corona radiata, gangliocapsular midbrain, middle cerebellar peduncle, and medial cerebellar hemispheres. The MR images were consistent with ADEM Figures 1 and 2.

Acute disseminated encephalomyelitis presenting as depressive episode

Krishnakumar P, Jayakrishnan MP, Devarajan E - Indian J Psychiatry (2011)

Bottom Line: A 9-year-old girl presented to the Child Guidance Clinic with clinical features suggestive of depressive episode of 1 week duration.There was history of short febrile illness 3 weeks prior to the onset of the depressive symptoms.MRI scan of brain showed features of acute disseminated encephalomyelitis.

Affiliation: Child Development Services, Institute of Mental Health and Neurosciences (IMHANS), Medical College, Calicut, Kerala, India. krikurp@gmail.com

ABSTRACT
A 9-year-old girl presented to the Child Guidance Clinic with clinical features suggestive of depressive episode of 1 week duration. There was history of short febrile illness 3 weeks prior to the onset of the depressive symptoms. MRI scan of brain showed features of acute disseminated encephalomyelitis.

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