Related Experiment Video

Updated: Aug 18, 2026

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
26:48

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis

Published on: July 4, 2007

Adult acute disseminated encephalomyelitis associated with poststreptococcal infection

M M Ning1, S Smirnakis, K L Furie

  • 1Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|April 27, 2005
PubMed

Insights

Acute disseminated encephalomyelitis (ADEM) in adults can be triggered by streptococcal pharyngitis, distinct from childhood cases. This case highlights unique MRI and CSF findings in adult ADEM.

Area of Science:

  • Neuroimmunology
  • Infectious Diseases
  • Demyelinating Diseases

Background:

  • Acute disseminated encephalomyelitis (ADEM) is typically a monophasic illness following viral infections, involving immune cross-reactivity to neural epitopes.
  • Post-streptococcal infections commonly cause pediatric autoimmune neuropsychiatric disorders, including ADEM, Sydenham's chorea, and PANDAS.
  • Adult-onset ADEM is less common and often associated with different triggers and clinical presentations compared to pediatric cases.

Observation:

  • A novel case of adult-onset ADEM is presented, clearly linked to documented streptococcal pharyngitis.
  • The patient exhibited elevated antideoxyribonuclease B (ADNB) titers, confirming a recent streptococcal infection.
  • Cerebrospinal fluid (CSF) analysis revealed significant leukocytosis.

Findings:

  • The adult ADEM case presented with an absence of basal ganglia abnormalities on magnetic resonance imaging (MRI).
  • Elevated ADNB titers in an adult with ADEM suggest a post-streptococcal etiology.
  • Distinctive CSF leukocytosis and lack of basal ganglia lesions differentiate this adult ADEM case from typical childhood ADEM and adult viral demyelinating diseases.

Implications:

  • This case expands the understanding of ADEM's etiology, demonstrating a link to streptococcal infections in adults.
  • The findings suggest that adult ADEM may have distinct diagnostic criteria, particularly regarding neuroimaging and CSF analysis.
  • Recognizing streptococcal triggers in adult ADEM is crucial for accurate diagnosis and potentially targeted treatment strategies.

More Related Videos

Induction and Diverse Assessment Indicators of Experimental Autoimmune Encephalomyelitis06:19

Induction and Diverse Assessment Indicators of Experimental Autoimmune Encephalomyelitis

Published on: September 9, 2022

Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Rocky Mountain Spotted Fever01:26

Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Arboviral Encephalitis01:25

Arboviral Encephalitis

Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...