How is acute disseminated encephalomyelitis (ADEM) distinguished from multiple sclerosis (MS)?

Updated: Oct 08, 2019
  • Author: Christopher Luzzio, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Answer

ADEM is considered an isolated postinfectious or postvaccination autoimmune attack on the CNS that leads to diffuse demyelination. ADEM is characterized by acute onset of motor, sensory, cerebellar, and cranial nerve dysfunction with encephalopathy, progressing to coma and eventual death in 30% of cases. Occasionally, ADEM has a fulminant hemorrhagic component, in which case it is termed acute hemorrhagic encephalomyelitis or leukoencephalitis of Weston Hurst.

MRI of the brain may be helpful for showing additional lesions in cases of MS or ADEM. This condition usually responds to steroid therapy; therefore, a treatment trial is often considered before proceeding with biopsy. This process is typically monophasic.


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