Brain MRI of a child with acute disseminated encephalomyelitis (ADEM) with subsequent development of mesial temporal sclerosis (MTS)

Brain MRI of a three-year old child with ADEM who subsequently developed right mesial temporal sclerosis. Transverse-axial FLAIR (A, B) and coronal T2 with fat-saturation (C) images demonstrate multiple "fluffy" hyperintense lesions in subcortical white matter and right thalamus. Note normal morphology of both hippocampal formations (C). Small foci of largely peripheral enhancement of white matter lesions is shown on post-contrast T1-weighted image (D). At follow-up one year later, there are small and hyperintense lesions in the right hippocampus on coronal T2 with fat-saturation (E and inset) and FLAIR (F and inset) MR images, respectively. In addition, there has been interval cerebral atrophy.