Acute Disseminated Encephalomyelitis (ADEM): Current View into Etiopathogenesis and Clinical Features

Area of Science:

• Neuroimmunology
• Neurology
• Demyelinating Diseases

Background:

• Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated demyelinating disorder of the central nervous system (CNS).
• Its etiopathogenesis remains poorly understood, often triggered by infections or immunizations.
• Diagnosis is challenging due to lack of specific biomarkers and overlap with other demyelinating syndromes.

Purpose of the Study:

• To review current knowledge on ADEM's etiopathogenesis and clinical characteristics.
• To highlight recent research implications for clinical practice and disease management.
• To discuss diagnostic challenges and heterogeneity of ADEM.

Main Methods:

• This is a narrative review.
• It synthesizes current literature on ADEM.
• Emphasis is placed on immunopathogenesis and clinical/radiological features.

Main Results:

• Post-infectious immune mechanisms like molecular mimicry and BBB disruption are key.
• Diverse triggers include infections, vaccinations, and genetic factors.
• Clinical and neuroimaging features can aid differentiation, but diagnostic limitations persist.

Conclusions:

• ADEM pathogenesis is complex, involving immune dysregulation leading to CNS demyelination.
• Recent advances in immunopathogenesis offer insights into diagnosis and management.
• Recognizing ADEM's heterogeneity is vital for effective clinical approaches.