Acute disseminated encephalomyelitis - a monophonic illness

Acute Disseminated Encephalomyelitis (ADEM) is an autoimmune condition frequently caused by infections or immunisation activities and is characterised by inflammation and demyelination in the central nervous system (CNS). It primarily affects the brain and spinal cord, typically triggered by an immune response, and most often occurs in children but can also affect adults. The condition usually presents with a rapid onset of neurological symptoms and is considered a monophasic illness, meaning it generally occurs as a single episode. Its attack leads to inflammation and demyelination, impairing nerve signal transmission. Although the exact mechanism is not fully understood, molecular mimicry is thought to play a role, wherein an infection induces an immune response that mistakenly targets CNS antigens resembling the infectious agent. Despite improvements in knowledge and therapies, ADEM is still difficult to diagnose and treat. This chapter covers ADEM's diagnosis, etiology, prognosis, and clinical aspects. It emphasises the interactions between the immune system and the CNS, the individualised treatment plans, and the role of neuroimaging and cerebrospinal fluid investigations in diagnosis. Promising immunomodulatory medications and customised medicine strategies are being developed to enhance patient outcomes, even if corticosteroids are still the primary therapy.