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

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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Clinically, acute disseminated encephalomyelitis (ADEM) is usually readily distinguishable from multiple sclerosis (MS) by the presence of certain clinical features, including the following:

  • History of preceding infectious illness or immunization, although a clear preceding event may be absent in up to a quarter of patients. [85]

  • Association with constitutional symptoms and signs, such as fever

  • Prominence of cortical signs such as mental status changes and seizures

  • Comparative rarity of posterior column abnormalities, which are common in MS

  • Age younger than 11-12 years in ADEM and age older than 11-12 years in MS

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