Acute Disseminated Encephalomyelitis

Abstract

Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory disease of the central nervous system (CNS) which is diagnosed more frequently today than in the past, but for which there are no controlled epidemiological data. In children, especially in the first ten years of age, the disease shows a mainly “encephalitic” pattern, albeit with varying clinical features, while in adults ADEM may be more “indolent”, sometimes with an unfavourable prognosis. Although ADEM was considered a monophasic disease until a decade ago, cases characterized by a recurrent-relapsing course have been reported, making the differential diagnosis with multiple sclerosis (MS) more difficult. Due to the wide clinical variability of ADEM, little is known about its etiology or patient predisposition. Prognosis is also difficult, since there are no guidelines as to the choice and length of treatment. For differential diagnosis with MS, careful monitoring not only of clinical findings but also of neuroradiological (MRI), biological (cerebrospinal fluid), and neurophysiological (EEG and EP) data is necessary.