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Updated: Aug 20, 2026

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
[Acute disseminated encephalomyelitis. Pathogenesis, diagnosis, treatment, and prognosis]
O Stüve1, S Nessler, H P Hartung
1Neurologische Klinik, Heinrich-Heine-Universität Düsseldorf. olaf.stueve@uni-duesseldorf.de
Insights
Acute disseminated encephalomyelitis (ADEM) is a CNS demyelinating disease often following infection or vaccination. Diagnosis relies on symptoms, MRI, and sometimes CSF analysis, with treatment involving anti-inflammatory and immunosuppressive therapies.
Area of Science:
- Neurology
- Immunology
- Pathology
Context:
- Acute disseminated encephalomyelitis (ADEM) is a rare, inflammatory, demyelinating disease of the central nervous system (CNS).
- It predominantly affects children and is typically monophasic, often triggered by infections or vaccinations.
- Understanding the autoimmune mechanisms in ADEM is crucial for diagnosis and treatment.
Purpose:
- To summarize the key features of Acute Disseminated Encephalomyelitis (ADEM).
- To highlight diagnostic criteria and common triggers.
- To outline current treatment strategies and prognosis.
Summary:
- ADEM is characterized by acute neurological symptoms following infection or vaccination, with multifocal white matter lesions on MRI.
- Cerebrospinal fluid (CSF) may show mild pleocytosis and elevated protein, but oligoclonal bands are inconsistent.
- Animal models suggest autoimmune responses play a role in CNS inflammation and demyelination.
Impact:
- Provides a concise overview of ADEM for clinicians and researchers.
- Emphasizes the importance of temporal association with triggers for diagnosis.
- Informs therapeutic approaches focusing on anti-inflammatory and immunosuppressive treatments.
Abstract:
Acute disseminated encephalomyelitis (ADEM) is typically a monophasic, demyelinating disease of the CNS that predominantly affects children. Typically, its clinical symptoms follow an infection or vaccination. In this regard, numerous viral and bacterial pathogens as well as several vaccinations have been associated with ADEM. Studies from animal models suggest that primary and secondary autoimmune responses may contribute to CNS inflammation and demyelination in ADEM. The diagnosis of ADEM is strongly suggested by a close temporal relationship between a viral infection or immunization and the onset of neurologic symptoms, and it is supported by extensive, multifocal, subcortical white-matter disease on brain magnetic resonance imaging. While mild lymphocytic pleocytosis and elevated proteins are detectable in the CSF in ADEM, oligoclonal bands are not always present. Treatment of this disorder consists of anti-inflammatory and immunosuppressive therapies, and the prognosis is generally considered favorable.
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