Acute disseminated encephalomyelitis progressing to multiple sclerosis: are infectious triggers involved?

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Daniel S Smyk1, Anaïs K Alexander, Mary Walker

  • 1Institute of Liver Studies, Division of Transplantation Immunology and Mucosal Biology, King's College London School of Medicine at King's College Hospital, Denmark Hill Campus, London, SE5 9RS, UK, daniel.s.smyk@doctors.org.uk.

Immunologic Research
|March 27, 2014
PubMed

Insights

Acute disseminated encephalomyelitis (ADEM) can progress to multiple sclerosis (MS), presenting a diagnostic challenge. This review explores infectious agents potentially triggering this transition, aiding in understanding ADEM to MS pathogenesis.

Area of Science:

  • Neuroimmunology
  • Infectious Diseases

Background:

  • Acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) are central nervous system demyelinating disorders with proposed autoimmune etiologies.
  • ADEM typically affects adolescents post-infection or vaccination and usually resolves, while MS follows a relapsing-remitting course.
  • The pathogenesis of MS is complex, involving genetic and environmental factors, with viruses like Epstein-Barr virus implicated as triggers.

Purpose of the Study:

  • To review evidence linking infectious agents to the progression of ADEM to MS.
  • To suggest methods for identifying infectious agents responsible for ADEM to MS pathogenesis.

Main Methods:

  • Literature review examining studies on ADEM and MS.
  • Analysis of proposed infectious triggers for ADEM.
  • Exploration of diagnostic challenges in differentiating ADEM from early MS.

Main Results:

  • Both ADEM and MS share clinical and pathological similarities, complicating diagnosis.
  • Some ADEM cases transition to MS, with the underlying reasons currently unclear.
  • Various viruses are investigated as potential infectious triggers for ADEM and MS.

Conclusions:

  • Identifying infectious agents is crucial for understanding ADEM to MS progression.
  • Further research into specific viral triggers may elucidate pathogenesis and improve diagnostic strategies.
  • Distinguishing ADEM from a first MS episode remains a significant clinical challenge.

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