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Combined central and peripheral nervous system involvement in acute disseminated encephalomyelitis in a young male: A

Aasim Ali1, Muhammad Shamoon1, Muhammad Asad Shabbir2

  • 1Neurology Department, Allied Hospital Faisalabad, Faisalabad, Pakistan.

Medicine
|May 1, 2026
PubMed
Abstract

Insights

This case study describes a rare instance of Acute Disseminated Encephalomyelitis (ADEM) affecting the peripheral nervous system in a young adult, presenting as motor axonal neuropathy. Prompt treatment with plasma exchange led to significant recovery and lesion resolution.

Area of Science:

  • Neuroimmunology
  • Demyelinating Disorders
  • Peripheral Neuropathy

Background:

  • Acute disseminated encephalomyelitis (ADEM) is an autoimmune CNS demyelinating disorder.
  • Rarely, ADEM can affect the peripheral nervous system, causing axonal neuropathy, posing diagnostic challenges.

Purpose of the Study:

  • To report a case of ADEM with peripheral nervous system involvement.
  • To highlight the diagnostic and therapeutic considerations for this rare presentation.

Main Methods:

  • A 22-year-old male presented with symptoms following a respiratory infection.
  • Diagnostic workup included MRI, CSF analysis, and nerve conduction studies.
  • Treatment involved high-dose methylprednisolone and therapeutic plasma exchange.

Main Results:

  • MRI showed white-matter hyperintensities.
  • Nerve conduction studies revealed predominantly motor axonal neuropathy with sensory sparing.
  • The patient showed significant motor recovery and complete lesion resolution within 3 months.

Conclusions:

  • This case underscores a rare ADEM presentation with peripheral nerve involvement in a young adult.
  • Early recognition and intervention, including plasma exchange, are crucial for favorable outcomes in such cases.
Keywords:
MRIacute disseminated encephalomyelitismotor axonal neuropathyperipheral neuropathyplasma exchangeyoung adult

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