Acute disseminated encephalomyelitis: A follow-up study of 40 adult patients

Abstract

Many patients initially diagnosed with ADEM develop clinically definite MS upon long-term follow-up. The authors found no useful diagnostic criteria for the differentiation of a first episode of MS from monophasic ADEM. The term ADEM may still be employed as a description of a clinical syndrome, but should not be used as a distinct entity until reliable diagnostic criteria have been developed.

Acute disseminated encephalomyelitis: clinical features, HLA DRB1*1501, HLA DRB1*1503, HLA DQA1*0102, HLA DQB1*0602, and HLA DPA1*0301 allelic association study

“…The CSF analysis in our series showed pleocytosis in only one patient, different from literature that usually find it, but the rarity of intrathecal band found here is in according with other studies 33,34 . Besides these findings, CSF results are not distinctive enough to allow discrimination between ADEM and MS.…”

Acute disseminated encephalomyelitis with medial temporal lesions mimicking acute limbic encephalitis

“…Magnetic resonance images (MRI) findings in ADEM have been reported in several studies; typical ADEM lesions are multifocal white matter lesions in the cerebrum [1,2], and cerebral cortical involvement has also been reported [1,[3][4][5][6]. In this case report, we describe an ADEM patient with medial temporal cortical lesions mimicking acute limbic encephalitis on MRI.…”

“…Concerning the limbic lesions, only one case of acute hemorrhagic leukoencephalitis, a more severe form of ADEM, has been reported to have features mimicking herpetic encephalitis [12]. Although multifocal white matter lesions are found in ADEM patients, several ADEM patients have been reported with cerebral cortical lesions [1,[3][4][5][6], suggesting that medial temporal lobes could be affected in patients with ADEM.…”

“…Concerning normal CSF findings and the absence of demyelinating lesions detected on MRI, several ADEM patients that lacked pleocytosis or MRI findings have been reported [4,13]. The diagnosis of ADEM requires the following: acute onset, symptoms and signs of disseminated multifocal central nervous system involvement and an antecedent infection or vaccination [1,6,13]; MRI findings are frequently normal even in patients with severe clinical manifestations [13].…”

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

“…Outcome is poor in patients who have AHLE, with mortality approaching 70% [62]. Patients with ADEM have a much better outcome, but approximately one third of them will go on to develop MS [76].…”