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Severe acute disseminated encephalomyelitis complicating measles infection
  1. Hamish Duncan Morrison1,2,
  2. Clemency Clarke3,
  3. Richard James4 and
  4. Nicola Giffin1
  1. 1Neurology, Royal United Hospital Bath NHS Trust, Bath, Bath and North East Somer, UK
  2. 2Bristol Medical School (PHS), University of Bristol, Bristol, UK
  3. 3Medicine, University Hospitals Bristol NHS Foundation Trust, Bristol, Bristol, UK
  4. 4Radiology, Royal United Hospital Bath NHS Trust, Bath, Bath and North East Somer, UK
  1. Correspondence to Dr Hamish Duncan Morrison; hamish.morrison{at}


A 36-year-old man presented with an acute progressive encephalopathy, followed by tetraparesis and was diagnosed with acute disseminated encephalomyelitis (ADEM) complicating infection with measles virus. Despite demonstrating a typical rash and other early symptoms of measles infection, there was uncertainty around the initial diagnosis. Cerebrospinal fluid analysis and MRI of the brain and spinal cord were consistent with severe ADEM. He required treatment on intensive care but responded favourably to immunosuppressive therapy.

This case highlights the importance of recognising acute measles infection, familiarity with the neurological complications and the potential for good outcome. Healthcare professionals must continue to play an active role in educating the public on the importance of maintaining herd immunity through universal immunisation.

  • vaccination/immunisation
  • infection (neurology)
  • neuroimaging
  • neuro ITU

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  • Contributors HDM drafted the first manuscript, collated revisions and prepared the final manuscript for submission. CC and NG contributed substantially to the revision of the manuscript. RJ produced the figures and contributed to the revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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