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Acute Disseminated Encephalomyelitis

 Syn. ADEM , Postinfectious encephalomyelitis

Signs & Symptoms

 Prodromal bacterial infection
Note: 1 month prior to the onset of typical neurologic symptoms
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults] Harrison [ 3200]
Motor deficits
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults]
Tetraparesis
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults]
Prodromal Viral infection
Note: 1 month prior to the onset of typical neurologic symptoms
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults] Harrison [ 3200]

Physical Examination

 Seizures
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults] Harrison [ 3200]
Acute hemorrhagic encephalomyelitis
Note: Hyperacute variants of ADEM - more rapidly progressive and more severe than typical ADEM
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults]
Rapid progression to coma
Note: due to AHEM
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults]

Lab / Serology

 Cerebrospinal fluid signs
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults -Acute disseminated encephalomyelitis in children: Pathogenesis, clinical features, and diagnosis]
Lymphocytic pleocytosis in CSF
Note: Generally ≥200 cells/μL
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults] Harrison [ 3200]
Red blood cells in CSF
Note: due to AHEM
Ref: Uptodate [ Acute disseminated encephalomyelitis in children: Pathogenesis, clinical features, and diagnosis]

Imagin Study

 Large confluent intramedullary lesions in Spinal cord on MRI
Ref: Uptodate [ Acute disseminated encephalomyelitis in children: Pathogenesis, clinical features, and diagnosis]
Multiple lesions in the deep and subcortical white matter on MRI
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults]
Widely scattered foci of perivenular demyelination of white matter
Ref: Harrison [ 3200]

Complication

 Coma
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults] Harrison [ 3200]
Respiratory failure
Ref: Uptodate [ Acute disseminated encephalomyelitis in children: Pathogenesis, clinical features, and diagnosis]
Death
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults]

Risk Factors

Cause

 Prodromal bacterial infection
Note: 1 month prior to the onset of typical neurologic symptoms
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults] Harrison [ 3200]
Prodromal Viral infection
Note: 1 month prior to the onset of typical neurologic symptoms
Ref: Uptodate [ Acute disseminated encephalomyelitis in adults] Harrison [ 3200]
Varicella infections
Ref: Harrison [ 3200]

Other