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Malignant Acute Disseminated Encephalomyelitis (ADEM) Presenting as a Stroke Alert: A Case Report
Madeline J Hooper1, Joshua A Kalter1, Nicholas S Imperato1
1Department of Emergency and Hospital Medicine, University of South Florida Morsani College of Medicine/Lehigh Valley Health Network Campus, Allentown, USA.
Cureus
|June 14, 2022
Summary
Acute disseminated encephalomyelitis (ADEM) is a rare neurological disorder. This case highlights a rare hyperacute ADEM presentation mimicking stroke, leading to rapid decline despite stroke alert protocols.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated demyelinating disease.
- ADEM typically presents with encephalopathy and focal neurological deficits.
Observation:
- A patient presented with symptoms suggestive of acute stroke, triggering a stroke alert protocol.
- Initial presentation mimicked an acute ischemic event, necessitating rapid diagnostic evaluation.
Findings:
- The definitive diagnosis was hyperacute or malignant ADEM, a rare and aggressive form.
- The patient experienced a rapid, treatment-refractory clinical decline.
Implications:
- This case underscores the importance of considering ADEM in stroke mimics.
- Early recognition and differentiation from stroke are critical for appropriate management, though hyperacute ADEM poses significant therapeutic challenges.
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