Demyelinating Diseases USMLE Step 1 Practice Question
A 7-year-old boy presents with fever (39.2°C), headache, confusion, and multifocal neurologic deficits 10 days after recovery from viral upper respiratory infection. Vital signs show HR 102/min, RR 22/min, BP 108/70 mmHg, SpO2 98% on room air. CSF analysis reveals elevated protein (62 mg/dL) and mild lymphocytic pleocytosis. MRI demonstrates widespread bilateral inflammatory demyelinating white matter lesions. No focal hemorrhage noted on imaging. Which of the following is the most likely diagnosis?
Answer choices
- AMultiple sclerosis
- BProgressive multifocal leukoencephalopathy
- CAcute disseminated encephalomyelitisCorrect answer
- DCentral pontine myelinolysis
- EGuillain Barré syndrome
- FSubacute sclerosing panencephalitis
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