Acute Disseminated Encephalomyelitis
- PMID: 28613684
- Bookshelf ID: NBK430934
Acute Disseminated Encephalomyelitis
Excerpt
Acute disseminated encephalomyelitis (ADEM), or post-infectious encephalomyelitis, is an acute, intense, polyfocal, inflammatory autoimmune disorder affecting the central nervous system (CNS). Children are predominantly affected, yet adult cases are not uncommon. ADEM is characterized by demyelination in the brain and spinal cord, and occasionally the optic nerve, due to inflammation that occurs in response to a preceding infection or immunization. The diagnosis is mainly clinical, with typical imaging findings on brain magnetic resonance imaging (MRI). The International Pediatric Multiple Sclerosis Study Group developed the modern diagnostic criteria, defining ADEM as an acute demyelinating syndrome that requires the presence of encephalopathy, polyfocal CNS involvement, and demyelinating lesions on brain MRI.
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Sections
- Continuing Education Activity
- Introduction
- Etiology
- Epidemiology
- Pathophysiology
- Histopathology
- History and Physical
- Evaluation
- Treatment / Management
- Differential Diagnosis
- Prognosis
- Complications
- Deterrence and Patient Education
- Pearls and Other Issues
- Enhancing Healthcare Team Outcomes
- Review Questions
- References
References
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- Nishiyama M, Nagase H, Tomioka K, Tanaka T, Yamaguchi H, Ishida Y, Toyoshima D, Fujita K, Maruyama A, Sasaki K, Oyazato Y, Nakagawa T, Takami Y, Nozu K, Nishimura N, Nakashima I, Iijima K. Clinical time course of pediatric acute disseminated encephalomyelitis. Brain Dev. 2019 Jun;41(6):531-537. - PubMed
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- Krupp LB, Tardieu M, Amato MP, Banwell B, Chitnis T, Dale RC, Ghezzi A, Hintzen R, Kornberg A, Pohl D, Rostasy K, Tenembaum S, Wassmer E, International Pediatric Multiple Sclerosis Study Group International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult Scler. 2013 Sep;19(10):1261-7. - PubMed
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- Koelman DL, Mateen FJ. Acute disseminated encephalomyelitis: current controversies in diagnosis and outcome. J Neurol. 2015 Sep;262(9):2013-24. - PubMed
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