Acute disseminated encephalomyelitis

Abstract

ADEM is an acute inflammatory demyelinating disorder of the CNS characterized by the new onset of focal or multifocal neurological signs and symptoms coupled with neuroimaging evidence of multifocal demyelinating lesions. ADEM frequently follows a recognized prodromal infectious illness or event. Maximal deficits are usually reached within one to two weeks. Treatment consists of supportive and symptomatic care and therapy targeted to the immune-mediated process. No controlled clinical trials have been conducted to define the most effective therapy. It is suggested that high dose IV methylprednisolone shortens the course of the illness and is associated with a better outcome. Resolution of signs and symptoms typically occurs rapidly, but in some cases may take weeks to months to resolve and may not be complete.