Acute disseminated encephalomyelitis (original) (raw)
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Pattern and Outcome of Acute Disseminated Encephalomyelitis (ADEM)
The Egyptian Journal of Hospital Medicine, 2019
Background: Acute disseminated encephalomyelitis (ADEM) is an immune disease marked by widespread of inflammation in the brain and spinal cord. ADEM typically damages myelin, causing destruction of white matter. It often occurs following a viral infection or vaccination. Its symptoms are similar to multiple sclerosis (MS) and are considered part of the multiple sclerosis borderline diseases. Patients and Methods: This is an observational prospective study done in Bab Al-Shariah University Hospital in period between 31th of December 2017 to 30th of December 2018 on children from birth to 18 years old who were having definite ADEM by neuroradiological study of the brain (MRI brain) presented to the Neuropediatric outpatients clinic or inpatients of Pediatric Department during the period of the study. Those with history suggestive of definite perinatal asphyxia or with other congenital malformation of neurological system were not involved in our study. Results: We found that the most c...
Pakistan Journal of Neurological Sciences, 2013
Acute disseminated encephalomyelitis (ADEM) is one of the demyelinating disorders of central nervous system (CNS) causing acute or relapsing-remitting encephalopathy. We report a male child, who presented with fever, fits and altered sensorium, with two identical events, 3½ months apart. Neuroimaging showed high signal lesions on the T2 weighted images reflecting areas of demyelination and edema, consistent with ADEM. He responded with complete recovery after pulse steroids and intravenous immunoglobulin (IVIG) therapy.
Atypical Presentation of Acute Disseminated Encephalomyelitis (ADEM) in a Middle-Aged Adult
The American Journal of Case Reports, 2019
Patient: Male, 47 Final Diagnosis: Acute disseminated encephalomyelitis (ADEM) Symptoms: Spastic paresis Medication: Methylprednisolone Clinical Procedure: — Specialty: General and Internel Medicine Objective: Rare disease Background: Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease that usually presents in pediatric patients, usually following a viral or bacterial infection. The clinical findings in ADEM include acute neurologic decline that typically presents with encephalopathy, with some cases progressing to multiple sclerosis. An atypical case of ADEM is reported that presented in a middle-aged adult. Case Report: A 46-year-old Caucasian man, who had recently emigrated to the US from Ukraine, presented with gait abnormalities that began four days after he developed abdominal cramps. Magnetic resonance imaging (MRI) of the brain with contrast, fluid-attenuated inversion recovery (FLAIR), and T2-weighting showed contrast-enhancing, patchy, diffuse lesions in...
Brain, 2000
Forty-eight children with disseminated demyelination of the CNS, 28 with acute disseminated encephalomyelitis (ADEM), seven with multiphasic disseminated encephalomyelitis (MDEM) and 13 with multiple sclerosis were studied for a mean follow-up period of 5.64 years. The presentation findings of the ADEM/MDEM group were compared with those of the multiple sclerosis group. The following findings were more commonly seen in ADEM/MDEM presentation compared with the multiple sclerosis presentations: predemyelinating infectious disease (74 versus 38%, P < 0.05); polysymptomatic presentation (91 versus 38%, P < 0.002); pyramidal signs (71 versus 23%, P < 0.01); encephalopathy (69 versus 15%, P < 0.002); and bilateral optic neuritis (23 versus 8%, not significant). Seizures occurred only in the ADEM/ MDEM group (17 versus 0%, not significant). Unilateral optic neuritis occurred only in the multiple sclerosis patients (23 versus 0%, P < 0.01). There were no differences in the frequencies of transverse myelitis, brainstem involvement, cerebellar signs and sensory disturbance between the two groups. ADEM/MDEM patients were more likely to have blood leucocytosis (64 versus 22%, P < 0.05), CSF lymphocytosis (64 versus 42%, not significant) and CSF protein elevation (60 versus Abbreviations: ADEM ϭ acute disseminated encephalomyelitis; MDEM ϭ multiphasic disseminated encephalomyelitis; VEP ϭ visual evoked potential
Acute Disseminated Encephalomyelitis A Case Series
. CT scan showed non specific hypodensity in 4 cases and was normal in 3 patients . MRI showed characteristic radiological changes. Complete recovery was seen in 3 patients , one died and 3 were left with sequelae.
Acute Disseminated Encephalomyelitis in a Six-Year-Old Child: A Case Report
Cureus
Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune demyelinating disorder that primarily affects the central nervous system (CNS). It is characterized by an acute inflammatory response targeting the myelin sheath surrounding nerve fibers in the brain and spinal cord. The exact mechanism of ADEM is not fully understood, but it is believed to involve an abnormal immune response that leads to the activation of immune cells and subsequent inflammation within the CNS. This immune-mediated attack results in the destruction of myelin, impairing the transmission of nerve signals and causing a wide range of neurological symptoms. This is a case of a six-year-old girl with no notable medical history presented with complaints of a fever and headache for the last month, in addition to difficulty walking for 20 days and speaking for 14 days. On CNS examination, the right upper and lower limbs' power was reduced, and the Babinski sign was seen in both lower limbs. Both sides of the triceps and knee showed increased reflexes, whereas both sides of the ankle showed decreased reflexes. Magnetic resonance imaging (MRI) showed multiple T1 hypointensities and T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) hyperintensities in the subcortical white matter of the bilateral frontal and parietal lobes, bilateral cerebellar peduncles, corpus callosum, pons, and midbrain. Our case report aims to raise awareness and aid in the early recognition of ADEM because prompt recognition, accurate diagnosis, and appropriate management are essential to minimizing neurological damage and promoting favorable outcomes in affected individuals.
Acute Diseminated Encephalomyelitis: A Case Report and Review of Literature
Acute disseminated encephalomyelitis (ADEM) is an autoimmune and monophasic central nervous system disease that principally affects brain and spinal cord by causing non-vasculitic inflammatory diffuse demyelination. ADEM is one of the rare causes of impaired consciousness in childhood. Incidence of the disease under the age of 20 is 1.5-3 / 100000 per year and it mostly occurs in children between the ages of 5-8 years. Underlying causes aren't defined clearly yet, however, infections and vaccinations are known as predisposing factors for the disease. Multifocal white matter lesions on magnetic resonance imaging (MRI) are characteristic signs of ADEM. In our case, hyperintense lesions in cerebrum were detected on cranial MRI subsequent to impaired consciousness and convulsion. No specific feature was found in cerebrospinal fluid analysis of the patient. In this paper, we present a three-year-old boy who developed ADEM subsequent to viral upper respiratory tract infection and had full recovery after high dose steroid therapy. Keywords: Acute Disseminated Encephalomyelitis; Cranial MRI; Multiple Lesions; High Dose Steroid Treatment.
Acute disseminated encephalomyelitis in children: one medical center experience
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi
Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory demyelinating disease of the central nervous system. The experience in children is limited. We retrospectively reviewed our experience with 20 ADEM patients (10 females, 10 males) with age of onset before 18 years old in Taiwan to clarify the clinical manifestations, neuroimaging findings, and the relationship between ADEM and multiple sclerosis (MS). The age at onset ranged from 4 months to 15 years. Seventeen (85%) children had a recent infectious prodrome. Children presented most often with acute consciousness disturbance (70%) and motor deficits (55%). Seizures occurred in 10 (50%), but only one child developed epilepsy in follow-up. Brain magnetic resonance imaging (MRI) evaluations done in all patients revealed multifocal lesions, mainly in subcortical white matter (80%), brainstem (65%), basal ganglia (55%), cerebellum (45%), thalamus (40%), and periventricular white matter (35%). Spinal cord MRI was performed...