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ADEM is usually monophasic demyelinating disease of the central nervous system associated a clinical presentation of focal neurologic signs few days to several weeks after clinical onset of the viral infection or vaccine. Recurrent ADEM occur in 10 to 29% of children which is characterized by a second attack, involving the same anatomic areas, more than three months after the initial event. We describe a case of a boy with 7 years old, who was diagnosed epilepsy and hemiparesis. Patient had normal development, when at 5 years, he presented generalized tonic-clonic seizures and right hemiparesis. Carbamazepine was introduced for six months and an overall improvement was seen. During one year, he was asymptomatic and anticonvulsivant was suspended. Six months later, the epilepsy return and CBZ was restarted. One year later, he was admitted with abdominal pain, vomiting and right proportional hemiparesis. Neurological exam constated right low strength. The diagnostic procedures was performed by brain and neuroaxial MRI, which registered hyperintensity on T2 in the periventricular white matter , subcortical region , the right half of the midbrain and the right middle cerebellar peduncle. Presence of lesions in contact with the corpus callosum . Multiple foci of hyperintensity in the cervical and thoracic spinal cord , especially at the C1-C2 level. There isn’t contrast enhancement. Neurophysiologic study shows slow activity in the left frontal- central -temporal regions, compatible with focal epilepsy syndromes. Emphasize the importance to discuss ADEM and epilepsy like initial symptom.

Epilepsy; Hemiparesis; Syandrome