Acute leukoencephalopathy with restricted diffusion (ALERD)

Infectious causes

• Dengue haemorrhagic fever: this is the most frequent cause
• Human herpes virus-6
• Adenovirus
• Rotavirus
• Influenza
• Mycoplasma pneumoniae
• Enterovirus type coxsackie virus-A6
• Escherichia coli O157:H7
• Bocavirus

Non-infectious causes

Clinical features

Magnetic resonance imaging (MRI) brain

Treatment

Synonym

References

1. Kamate M, Detroja M, Hattiholi V. Acute leucoencephalopathy with restricted diffusion in children - a case series. Neurol India 2021; 69:466-469.
2. Lawrence RM, Aripirala P, Reddy N, et al. The spectrum of acute leukoencephalopathy with restricted diffusion (ALERD): A case series and review of literature. Eur J Paediatr Neurol 2021; 33:86-93.
3. Randhawa MS, Randhawa TS, Angurana SK, Ratho RK. Acute encephalopathy with biphasic seizures and late restricted diffusion temporally associated with human bocavirus infection. BMJ Case Rep 2022; 15:e251019.
4. Kamate M, Basavanagowda T, Hattiholi V. Venom-induced reversible leukoencephalopathy: a novel cause of toxic acute leukoencephalopathy with restricted diffusion. Pediatr Neurol 2023; 141:77-78.
5. Watanabe Y, Motoi H, Oyama Y, Ichikawa K, Takeshita S, Mori M, Nezu A, Yokota S. Cyclosporine for acute encephalopathy with biphasic seizures and late reduced diffusion. Pediatr Int 2014; 56:577-582.
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Related checklists

• Carbon monoxide (CO) leukoencephalopathy
• Delayed post-hypoxic leukoencephalopathy (DPHL)
• Methanol toxicity