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Journal of the Korean Child Neurology Society 2002;10(1):142-149.
Published online May 30, 2002.
High-dose Methylprednisolone Pulse Therapy in Measles Postinfectious Encephalomyelitis: Two Cases of Successful Recovery.
Me Jin Kim, Hee Jung Chung, Pyoung Jeon
1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea. agathac@nhimc.or.kr
2Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Kyunggi, Korea.
3Department of Diagnostic Radiology, National Health Insurance Corporation Ilsan Hospital, Kyunggi, Korea.
Abstract
We treated two patients of measles postinfectious encephalomyelitis with intravenous methylprednisolone pulse therapy(1 g/1.73 m2/day for 5 days) 38 hours and 5 days respectively after the onset of neurologic symptoms. Despite extensive white matter involvement shown in MRI and severe clinical symptoms, the patients recovered from their neurologic symptoms dramatically following intravenous methylprednisolone pulse therapy. Because acute postinfectious encephalomyelitis has been postulated to be immunologically mediated disease, instead of direct viral invasion, ACTH and dexamethasone are widely used and the outcome is variable. This case report of successful recovery from fulminant ADEM with pulse intravenous methylprednisolone therapy, although uncontrolled, suggests that this therapeutic regimen should be studied in other cases.
Key Words: Measles, Acute postinfectious encephalomyelitis, Methylprednisolone pulse therapy
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