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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

Post-infectious encephalomyelitis

Cornelia Mihai1, Burk Jubelt

  • 1SUNY Upstate Medical University, 750 E. Adams Street, Syracuse, NY 13210, USA. mihaic@upstate.edu.

Current Neurology and Neuroscience Reports
|November 3, 2005
PubMed

Insights

Post-infectious encephalomyelitis (PIEM) and acute disseminated encephalomyelitis (ADEM) are demyelinating central nervous system disorders. Clinical and MRI features help differentiate these from multiple sclerosis, with methylprednisolone often effective for treatment.

Area of Science:

  • Neurology
  • Immunology
  • Neuroimmunology

Background:

  • Post-infectious encephalomyelitis (PIEM) and acute disseminated encephalomyelitis (ADEM) are primary demyelinating disorders of the central nervous system.
  • These conditions are often confused with multiple sclerosis (MS) and Devic's disease.
  • Distinguishing between ADEM/PIEM and the initial presentation of MS can be challenging due to the lack of specific diagnostic tests.

Purpose of the Study:

  • To clarify the distinction between PIEM and ADEM.
  • To outline the diagnostic challenges in differentiating PIEM/ADEM from other demyelinating diseases.
  • To discuss the therapeutic strategies for PIEM/ADEM.

Main Methods:

  • Review of clinical and magnetic resonance imaging (MRI) features.
  • Comparison of diagnostic criteria for ADEM, PIEM, and MS.
  • Analysis of treatment outcomes for various therapeutic interventions.

Main Results:

  • PIEM follows a known infection, while ADEM lacks a clear antecedent infection.
  • Clinical and MRI findings can differentiate PIEM/ADEM from relapsing neurological diseases like MS.
  • Methylprednisolone is a common and often effective treatment.

Conclusions:

  • Accurate differentiation of PIEM/ADEM from other demyelinating disorders is crucial for appropriate management.
  • While spontaneous recovery occurs, most patients benefit from treatments like methylprednisolone.
  • Plasma exchange and intravenous immunoglobulin are effective alternatives when initial therapy fails.

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