A 23-year-old man presented to the clinic with a oneweek history of left upper and lower extremity numbness, starting in his left hand and progressing to his left foot. He then experienced intermittent difficulty walking and left-sided drooling. The patient also reported having a left arm abscess one week earlier, for which he received penicillin and oxycodone and acetaminophen. He denied any weakness, seizure, headache, fever, nausea, vomiting, or focal neurological deficit, as well as any recent history of immunization or upper respiratory infection symptoms. During the initial visit, magnetic resonance images were obtained. Over the course of the next year, the patient presented to the hospital six times for additional symptoms including weakness, slurred speech, and seizures. During this period, brain biopsy, serology tests, and MR spectroscopy were performed confirming the initial diagnosis. Moreover, multiple MR images were performed showing progression and relapsing.
Radiological diagnosis: Multiphasic Acute Disseminated Encephalomyelitis.