Acute Disseminated Encephalomyelitis after Oral Therapy with Herbal Extracts: A Case Report

Abstract

Background: Acute disseminated encephalomyelitis(ADEM) is a rare demyelinating disease of the centralnervous system, commonly attributed to infectionsor vaccinations. Toxic or allergenic compounds canalso trigger a response in the immune system and maycause demyelination. We present a case with ADEMafter using oral herbal medications.Case Report: A 25 year-old male developed bilateralcentral facial palsy and severe quadriparesis aftertaking herbal drugs (containing echinacea and manyother herbal ingredients) for two weeks. He had usedthe extract to increase his potency and reproductivity.He had no past history of recent immunization or viralinfection. The clinical findings, cerebrospinal fluid(CSF) analysis and brain magnetic resonance imaging(MRI) were compatible with ADEM. The neurologicalfindings were improved after seven doses of pulsemethylprednisolone treatment. To our knowledge,this is the third report in the literature that links herbaltherapy and demyelinating disease.Conclusion: Most of the ADEM cases related to herbaltherapy in the literature similarly used echinacea. Itis our opinion that other ingredients of the herbal extractused by our case, besides echinacea, could havethe potential to cause a trigger in the immune system.Further studies are needed to clarify the immunologicaleffects of different kinds of herbal compounds, aswell as the effects of different parts of the plants andthe results of various dosages. Moreover, ingredientsshould also be tested for toxicity, adverse effects anddrug interactions.