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Updated: May 12, 2026
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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
Isolated and persistent cognitive dysfunction in a patient with acute disseminated encephalomyelitis
Ivan Adamec1, Nataša Klepac, Danijela Kolenc
1epartment of Neurology, University Hospital Center Zagreb, Croatia.
Summary
This case report details acute disseminated encephalomyelitis (ADEM) presenting solely with cognitive symptoms in an adult. It underscores the importance of pathological evaluation for accurate ADEM diagnosis in adults.
Area of Science:
- Neuroscience
- Neurology
- Pathology
Background:
- Acute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating disease.
- Cognitive dysfunction is recognized in multiple sclerosis but rarely reported in adult ADEM.
- Diagnostic challenges exist for adult ADEM, particularly with atypical presentations.
Observation:
- A 35-year-old woman presented with isolated cognitive disturbances and demyelinating brain lesions on MRI.
- Comprehensive neuropsychological assessment revealed severe deficits in executive function, attention, verbal fluency, and memory.
- Neurologic examination, MRI, laboratory analyses, and visual evoked potentials were performed.
Findings:
- Brain biopsy and MRI confirmed the diagnosis of acute disseminated encephalomyelitis (ADEM).
- The patient exhibited significant impairments in mental flexibility, motor programming, and inhibitory control.
- Cognitive assessment scores fell below normal ranges on multiple standardized tests.
Implications:
- This case highlights the limitations of clinical presentation and neuroimaging in diagnosing adult ADEM.
- Current diagnostic criteria for ADEM in adults may be insufficient for atypical presentations.
- Pathological confirmation is crucial for accurate diagnosis of ADEM in adults, especially when cognitive symptoms predominate.
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