What is the prognosis of acute disseminated encephalomyelitis (ADEM)?

Updated: Nov 08, 2018
  • Author: J Nicholas Brenton, MD; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Morbidity chiefly includes visual, motor, autonomic, and behavioral/intellectual deficits and epilepsy. Based upon existing data, full recovery occurs in approximately 57-92% of patients. Residual focal neurologic deficits remain in 4-30%. [54, 47, 58, 60, 61, 62, 55, 63, 85] Neurocognitive deficits after acute demyelinating syndromes are receiving more attention, as even children having an apparent full recovery after ADEM have demonstrated subtle deficits on formal neuropsychological testing years after the sentinel event. [65] Additionally, these intellectual and behavioral impairments are variable depending on age of the child at the time of disease onset. There may be a greater impact upon behavior and intelligence in those with an ADEM-onset of younger than 5 years of age. [64]

Though uncommon, adult-onset ADEM, when correctly diagnosed, appears to have similar outcomes and a typically favorable prognosis. [39]

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