Necrotizing encephalitis with paraplegia - A case report

A case of acute onset of seizures, fever, change of consciousness and paraplegia was reported. The episode began with two attacks of generalized tonic-clonic seizures, fever and consciousness disturbance, followed by urinary incontinence and paraplegia with hyporeflexia. Magnetic resonance imaging of the brain gave a picture mimicking herpes simplex encephalitis. However, subsequent paraplegia and the negative result of polymerase chain reaction (PCR) in cerebrospinal fluid favors the diagnosis of acute disseminated encephalomyelitis. The patient recovered completely in one and half months later. The difficulty in diagnosing this category of diseases will be discussed with literature review.