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. 2014 Dec 23:5:270.
doi: 10.3389/fneur.2014.00270. eCollection 2014.

Refractory Fulminant Acute Disseminated Encephalomyelitis (ADEM) in an Adult

Federico Rodríguez-Porcel  1 , Alejandro Hornik  1 , Jordan Rosenblum  2 , Ewa Borys  3 , José Biller  1
Affiliations

Refractory Fulminant Acute Disseminated Encephalomyelitis (ADEM) in an Adult

Federico Rodríguez-Porcel et al. Front Neurol. .

Abstract

Acute disseminated encephalomyelitis (ADEM) is characterized by its rapid progression with variable symptoms and severity in adults and children. Multiple therapeutic options have been proposed, but solid evidence is yet to be gathered. We describe an adult man with a fulminant form of ADEM unresponsive to numerous treatment modalities.

Keywords: acute disseminated encephalomyelitis; corticosteroids; cyclophosphamide; intravenous immunoglobulin; plasmapheresis; rituximab.

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Figures

Figure 1
Figure 1
MRI (FLAIR) shows multiple rounded lesions throughout the brain parenchyma predominantly involving the white matter of both cerebral hemispheres, basal ganglia and midbrain.
Figure 2
Figure 2
MRI (FLAIR) shows increased number of supra and infratentorial lesions.
Figure 3
Figure 3
Luxol Fast Blue stain shows areas of demyelination with relative sparing of the axons with some axonal swellings.
See this image and copyright information in PMC

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