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Acute disseminated encephalomyelitis (ADEM)

Overview

ADEM is an acquired condition wherein demyelination takes place in the brain and spinal cord secondary to antecedent infection or immunization. It generally affects younger population, is usually monophasic, and does not tend to recur.

  • Fever
  • Headache
  • Meningism
  • Seizures
  • Altered mental state
  • Multiple neurological deficits

  • More common among children than adults
  • One is more likely to get ADEM soon after having an infection

Neurologist

  • CSF examination to determine the number of white blood cells, protein levels, and oligoclonal bands
  • MRI to check lesions involving grey matter, mass effect and enhancement after instilling contrast
  • Other diseases such as multiple sclerosis, myelin oligodendrocyte glycoprotein antibody disease (MOGAD), neuromyelitis optica, neurosarcoidosis, malignancy, and granulomas need to be ruled out

Five-day-course of intravenous immunoglobulin.

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