[From influenza to white matter]

Area of Science:

• Neurology
• Immunology
• Pediatrics

Background:

• Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated inflammatory demyelinating disease of the central nervous system.
• It typically presents with acute neurological deficits, often following an infection or vaccination.
• Early recognition is vital for appropriate management and to differentiate it from other neurological disorders.

Observation:

• A 16-year-old male presented with acute neurological symptoms suggestive of ADEM.
• Clinical presentation included impaired consciousness and characteristic magnetic resonance imaging (MRI) findings.
• The case highlights the importance of considering ADEM in the differential diagnosis of acute neurological presentations.

Findings:

• Diagnostic workup raised suspicion for ADEM based on clinical and MRI findings.
• Extensive microbiological sampling was deemed essential for accurate differential diagnosis.
• The case underscores the link between infections and the potential onset of ADEM.

Implications:

• Neurological symptoms occurring in conjunction with infections warrant consideration of ADEM.
• Timely diagnosis and appropriate investigations are critical for patient outcomes.
• This case contributes to the understanding of ADEM presentation in adolescents.