Related Experiment Video
Updated: Sep 30, 2025
Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
[Acute disseminated encephalomyelitis]
1Klinik für Diagnostische und Interventionelle Neuroradiologie, Uniklinikum des Saarlandes, Kirrbergerstraße 1, 66421, Homburg/Saar, Deutschland. m.wolska-krawczyk@uks.eu.
Background:
Acute disseminated encephalomyelitis (ADEM) is a rare demyelinating disease that occurs predominantly in children. According to the guidelines, ADEM belongs to the myelin oligodendrocyte glycoprotein (MOG)-associated diseases and usually manifests after febrile infections (also after SARS-CoV-2) or postvaccinally.
Objectives:
Incidence, course and clinical, and as well, as radiological features and new developments and treatment of ADEM.
Methods:
Analysis and review of the literature on ADEM and of notable cases and guidelines.
Results:
The first signs of ADEM include fever, nausea and vomiting, headache and meningism as well as, by definition, encephalopathy, which usually manifests as drowsiness and confusion. The radiological diagnosis is made by magnetic resonance imaging (MRI). Here, the asymmetrically distributed, diffuse and tumefactive lesions can be located supra- and infratentorially. In the acute phase, the lesions usually show contrast enhancement and restricted diffusion. Spinal involvement of the gray matter with the typical H‑pattern with myelitis transversa is not uncommon. ADEM has mostly a monophasic course, with a recurrent form ("relapsing ADEM") in 1-20% of cases. For treatment, steroids and in severe cases immunosuppressive drugs are used.
Conclusions:
ADEM is generally a monophasic disease whose symptoms usually last for a few weeks or months. It is crucial to differentiate ADEM from other demyelinating diseases, like for example multiple sclerosis, in order not to delay the proper treatment.
Insights
Acute disseminated encephalomyelitis (ADEM) is a rare demyelinating disease in children, often following infections or vaccinations. Early diagnosis and differentiation from conditions like multiple sclerosis are crucial for effective treatment.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Acute disseminated encephalomyelitis (ADEM) is a rare demyelinating disease predominantly affecting children.
- ADEM is classified as a myelin oligodendrocyte glycoprotein (MOG)-associated disease.
- It often follows febrile infections, including SARS-CoV-2, or vaccinations.
Purpose of the Study:
- To review the incidence, clinical course, and radiological features of ADEM.
- To discuss new developments and treatment strategies for ADEM.
- To highlight the importance of differentiating ADEM from other demyelinating conditions.
Main Methods:
- Comprehensive analysis and review of existing literature on ADEM.
- Inclusion of notable case studies.
- Consideration of current clinical guidelines.
Main Results:
- Initial symptoms include fever, headache, encephalopathy (drowsiness, confusion), and meningism.
- Magnetic resonance imaging (MRI) reveals diffuse, tumefactive lesions, often asymmetric, with contrast enhancement and restricted diffusion.
- Spinal cord involvement (myelitis transversa) with an H-pattern is observed in some cases.
Conclusions:
- ADEM typically follows a monophasic course, resolving within weeks to months.
- A relapsing form of ADEM occurs in 1-20% of cases.
- Prompt differentiation from diseases like multiple sclerosis is essential for appropriate management.
