Acuted Disseminated Encephalomyelitis

Abstract

Acute disseminated encephalomyelitis (ADEM) is a disorder of the central nervous system (CNS) characterized by an acute event, typically with encephalopathy, in which diffuse CNS involvement occurs. It may follow an infectious event and occurs more commonly in young children. Pulse steroid treatment is frequently used to treat ADEM. Although ADEM is typically described as a benign condition, with children generally recovering motor function and resolution of lesions on magnetic resonance imaging (MRI), residual cognitive deficits may occur. This chapter aims to review the clinical features, typical presentation, differential diagnosis, treatment and prognosis of ADEM.

Immunopathology of Japanese macaque encephalomyelitis is similar to multiple sclerosis

“…Animals presenting with JME possess immunological signatures that are more akin to immunopathogenesis of MS than those of ADEM (Parrish and Yeh, 2012, Wingerchuk and Lucchinetti, 2007, Steiner and Kennedy, 2015). This model has the potential to provide insight into a disease that has proven incredibly difficult to study, as the existing experimentally induced animal models do not recapitulate all aspects of MS (Procaccini et al, 2015).…”

A spectrum of inflammation and demyelination in acute disseminated encephalomyelitis (ADEM) of children

“…ADEM mainly affects children under 10 years, is more common in males [1,[8][9][10], and mostly arises 2 to 40 days after an infection or more rarely after vaccines [1,10,11]. In most cases ADEM follows a trivial infection, usually localized in the upper respiratory tract, whereas only less than 5% of cases can be classified as post-vaccine forms [12,13]. History of a precipitating event can be reported in 70-80% of children who are diagnosed with ADEM [2,10], but in almost 25% of patients no possible etiology can be identified [1,13,14].…”

“…Other pathogens anecdotally involved in ADEM have been Toxoplasma gondii [3], Plasmodium falciparum [28], Cryptococcus neoformans [29], Haemophilus influenzae type b [30], Leptospira sp. [31], Streptococcus pyogenes [32], Borrelia burgdorferi [33], atypical bacteria (i.e., Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila) [13], Rickettsia sp. [13], and Campylobacter jejuni [13].…”

“…[31], Streptococcus pyogenes [32], Borrelia burgdorferi [33], atypical bacteria (i.e., Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila) [13], Rickettsia sp. [13], and Campylobacter jejuni [13]. However, a microbiologic diagnosis is rarely reached despite the majority of patients has a positive history of recent previous infections.…”

Acute demyelinating encephalomyelitis presenting with psychiatric symptoms

“…Acute demyelinating encephalomyelitis (ADEM) is a rare disease of the white matter, and sometimes the grey matter, of the central nervous system. Most cases have onset in childhood, but adult onset cases have been reported (Parrish and Yeh, ). ADEM usually, but not always, follows a viral, bacterial or parasitic infection.…”