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ADEM
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Acute disseminated encephalomyelitis (ADEM)
            • Definitions

              • Para-/postinfectious immune-mediated inflammatory disorder of white matter

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nonvascular Interventions

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Baumann M et al: MRI of the first event in pediatric acquired demyelinating syndromes with antibodies to myelin oligodendrocyte glycoprotein. J Neurol. 265(4):845-55, 2018
                                          2. Mariotto S et al: Clinical spectrum and IgG subclass analysis of anti-myelin oligodendrocyte glycoprotein antibody-associated syndromes: a multicenter study. J Neurol. 264(12):2420-30, 2017
                                          3. Marziali S et al: Acute disseminated encephalomyelitis following Campylobacter jejuni gastroenteritis: case report and review of the literature. Neuroradiol J. 30(1):65-70, 2017
                                          4. Nakamura Y et al: Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report. BMC Neurol. 17(1):76, 2017
                                          5. Daida K et al: Cytomegalovirus-associated encephalomyelitis in an immunocompetent adult: a two-stage attack of direct viral and delayed immune-mediated invasions. case report. BMC Neurol. 16(1):223, 2016
                                          6. Pohl D et al: Acute disseminated encephalomyelitis: updates on an inflammatory CNS syndrome. Neurology. 87(9 Suppl 2):S38-45, 2016
                                          7. Yuan JL et al: Acute disseminated encephalomyelitis following vaccination against hepatitis B in a child: a case report and literature review. Case Rep Neurol Med. 2016:2401809, 2016
                                          8. Baumann M et al: Clinical and neuroradiological differences of paediatric acute disseminating encephalomyelitis with and without antibodies to the myelin oligodendrocyte glycoprotein. J Neurol Neurosurg Psychiatry. ePub, 2014
                                          9. Marin SE et al: The magnetic resonance imaging appearance of monophasic acute disseminated encephalomyelitis: an update post application of the 2007 consensus criteria. Neuroimaging Clin N Am. 23(2):245-66, 2013
                                          10. Wingerchuk DM et al: Acute disseminated encephalomyelitis, transverse myelitis, and neuromyelitis optica. Continuum (Minneap Minn). 19(4 Multiple Sclerosis):944-67, 2013
                                          11. Lim CC: Neuroimaging in postinfectious demyelination and nutritional disorders of the central nervous system. Neuroimaging Clin N Am. 21(4):843-58, viii, 2011
                                          12. Harris MO et al: Is it ADEM, POLG, or both? Arch Neurol. 67(4):493-6, 2010
                                          13. Ketelslegers IA et al: A comparison of MRI criteria for diagnosing pediatric ADEM and MS. Neurology. Epub ahead of print, 2010
                                          14. Summerfield R et al: Small cell lung carcinoma presenting with acute disseminated encephalomyelitis. Br J Radiol. 83(987):e54-7, 2010
                                          15. Young NP et al: Perivenous demyelination: association with clinically defined acute disseminated encephalomyelitis and comparison with pathologically confirmed multiple sclerosis. Brain. 133(Pt 2):333-48, 2010
                                          16. Hagiwara H et al: Acute disseminated encephalomyelitis developed after Mycoplasma pneumoniae infection complicating subclinical measles infection. Intern Med. 48(6):479-83, 2009
                                          17. Panicker JN et al: Lower urinary tract dysfunction in acute disseminated encephalomyelitis. Mult Scler. 15(9):1118-22, 2009
                                          18. Rossi A: Imaging of acute disseminated encephalomyelitis. Neuroimaging Clin N Am. 18(1):149-61; ix, 2008
                                          19. Balasubramanya KS et al: Diffusion-weighted imaging and proton MR spectroscopy in the characterization of acute disseminated encephalomyelitis. Neuroradiology. 49(2):177-83, 2007
                                          20. Khurana DS et al: Acute disseminated encephalomyelitis in children: discordant neurologic and neuroimaging abnormalities and response to plasmapheresis. Pediatrics. 116(2):431-6, 2005
                                          21. Dale RC: Acute disseminated encephalomyelitis. Semin Pediatr Infect Dis. 14(2):90-5, 2003
                                          22. Garg RK: Acute disseminated encephalomyelitis. Postgrad Med J. 79(927):11-7, 2003
                                          23. Idrissova ZhR et al: Acute disseminated encephalomyelitis in children: clinical features and HLA-DR linkage. Eur J Neurol. 10(5):537-46, 2003
                                          24. Miravalle A et al: Encephalitis complicating smallpox vaccination. Arch Neurol. 60(7):925-8, 2003
                                          25. Au WY et al: Acute disseminated encephalomyelitis after para-influenza infection post bone marrow transplantation. Leuk Lymphoma. 43(2):455-7, 2002
                                          26. Inglese M et al: Magnetization transfer and diffusion tensor MR imaging of acute disseminated encephalomyelitis. AJNR Am J Neuroradiol. 23(2):267-72, 2002
                                          27. Khong PL et al: Childhood acute disseminated encephalomyelitis: the role of brain and spinal cord MRI. Pediatr Radiol. 32(1):59-66, 2002
                                          28. Murthy SN et al: Acute disseminated encephalomyelitis in children. Pediatrics. 110(2 Pt 1):e21, 2002
                                          29. Arya SC: Acute disseminated encephalomyelitis associated with poliomyelitis vaccine. Pediatr Neurol. 24(4):325, 2001
                                          30. Bastianello S: Magnetic resonance imaging of MS-like disease. Neurol Sci. 22 Suppl 2:S103-7, 2001
                                          31. Lin WC et al: Sequential MR studies of a patient with white matter disease presenting psychotic symptoms: ADEM versus single-episode MS. Kaohsiung J Med Sci. 17(3):161-6, 2001
                                          32. Miyazawa R et al: Plasmapheresis in fulminant acute disseminated encephalomyelitis. Brain Dev. 23(6):424-6, 2001
                                          33. Singh S et al: Acute disseminated encephalomyelitis and multiple sclerosis: magnetic resonance imaging differentiation. Australas Radiol. 44(4):404-11, 2000
                                          34. Tsuru T et al: Acute disseminated encephalomyelitis after live rubella vaccination. Brain Dev. 22(4):259-61, 2000
                                          35. Murthy JM et al: Clinical, electrophysiological and magnetic resonance imaging study of acute disseminated encephalomyelitis. J Assoc Physicians India. 47(3):280-3, 1999
                                          36. Pradhan S et al: Intravenous immunoglobulin therapy in acute disseminated encephalomyelitis. J Neurol Sci. 165(1):56-61, 1999
                                          37. Murthy JM: MRI in acute disseminated encephalomyelitis following Semple antirabies vaccine. Neuroradiology. 40(7):420-3, 1998
                                          38. Kumada S et al: Encephalomyelitis subsequent to mycoplasma infection with elevated serum anti-Gal C antibody. Pediatr Neurol. 16(3):241-4, 1997
                                          39. Patel SP et al: Neuropsychiatric features of acute disseminated encephalomyelitis: a review. J Neuropsychiatry Clin Neurosci. 9(4):534-40, 1997
                                          40. Kinoshita A et al: Inflammatory demyelinating polyradiculitis in a patient with acute disseminated encephalomyelitis (ADEM). J Neurol Neurosurg Psychiatry. 60(1):87-90, 1996
                                          41. Kleiman M et al: Acute disseminated encephalomyelitis: response to intravenous immunoglobulin. J Child Neurol. 10(6):481-3, 1995
                                          42. Baum PA et al: Deep gray matter involvement in children with acute disseminated encephalomyelitis. AJNR Am J Neuroradiol. 15(7):1275-83, 1994
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Acute disseminated encephalomyelitis (ADEM)
                                                    • Definitions

                                                      • Para-/postinfectious immune-mediated inflammatory disorder of white matter

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nonvascular Interventions

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Baumann M et al: MRI of the first event in pediatric acquired demyelinating syndromes with antibodies to myelin oligodendrocyte glycoprotein. J Neurol. 265(4):845-55, 2018
                                                                                  2. Mariotto S et al: Clinical spectrum and IgG subclass analysis of anti-myelin oligodendrocyte glycoprotein antibody-associated syndromes: a multicenter study. J Neurol. 264(12):2420-30, 2017
                                                                                  3. Marziali S et al: Acute disseminated encephalomyelitis following Campylobacter jejuni gastroenteritis: case report and review of the literature. Neuroradiol J. 30(1):65-70, 2017
                                                                                  4. Nakamura Y et al: Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report. BMC Neurol. 17(1):76, 2017
                                                                                  5. Daida K et al: Cytomegalovirus-associated encephalomyelitis in an immunocompetent adult: a two-stage attack of direct viral and delayed immune-mediated invasions. case report. BMC Neurol. 16(1):223, 2016
                                                                                  6. Pohl D et al: Acute disseminated encephalomyelitis: updates on an inflammatory CNS syndrome. Neurology. 87(9 Suppl 2):S38-45, 2016
                                                                                  7. Yuan JL et al: Acute disseminated encephalomyelitis following vaccination against hepatitis B in a child: a case report and literature review. Case Rep Neurol Med. 2016:2401809, 2016
                                                                                  8. Baumann M et al: Clinical and neuroradiological differences of paediatric acute disseminating encephalomyelitis with and without antibodies to the myelin oligodendrocyte glycoprotein. J Neurol Neurosurg Psychiatry. ePub, 2014
                                                                                  9. Marin SE et al: The magnetic resonance imaging appearance of monophasic acute disseminated encephalomyelitis: an update post application of the 2007 consensus criteria. Neuroimaging Clin N Am. 23(2):245-66, 2013
                                                                                  10. Wingerchuk DM et al: Acute disseminated encephalomyelitis, transverse myelitis, and neuromyelitis optica. Continuum (Minneap Minn). 19(4 Multiple Sclerosis):944-67, 2013
                                                                                  11. Lim CC: Neuroimaging in postinfectious demyelination and nutritional disorders of the central nervous system. Neuroimaging Clin N Am. 21(4):843-58, viii, 2011
                                                                                  12. Harris MO et al: Is it ADEM, POLG, or both? Arch Neurol. 67(4):493-6, 2010
                                                                                  13. Ketelslegers IA et al: A comparison of MRI criteria for diagnosing pediatric ADEM and MS. Neurology. Epub ahead of print, 2010
                                                                                  14. Summerfield R et al: Small cell lung carcinoma presenting with acute disseminated encephalomyelitis. Br J Radiol. 83(987):e54-7, 2010
                                                                                  15. Young NP et al: Perivenous demyelination: association with clinically defined acute disseminated encephalomyelitis and comparison with pathologically confirmed multiple sclerosis. Brain. 133(Pt 2):333-48, 2010
                                                                                  16. Hagiwara H et al: Acute disseminated encephalomyelitis developed after Mycoplasma pneumoniae infection complicating subclinical measles infection. Intern Med. 48(6):479-83, 2009
                                                                                  17. Panicker JN et al: Lower urinary tract dysfunction in acute disseminated encephalomyelitis. Mult Scler. 15(9):1118-22, 2009
                                                                                  18. Rossi A: Imaging of acute disseminated encephalomyelitis. Neuroimaging Clin N Am. 18(1):149-61; ix, 2008
                                                                                  19. Balasubramanya KS et al: Diffusion-weighted imaging and proton MR spectroscopy in the characterization of acute disseminated encephalomyelitis. Neuroradiology. 49(2):177-83, 2007
                                                                                  20. Khurana DS et al: Acute disseminated encephalomyelitis in children: discordant neurologic and neuroimaging abnormalities and response to plasmapheresis. Pediatrics. 116(2):431-6, 2005
                                                                                  21. Dale RC: Acute disseminated encephalomyelitis. Semin Pediatr Infect Dis. 14(2):90-5, 2003
                                                                                  22. Garg RK: Acute disseminated encephalomyelitis. Postgrad Med J. 79(927):11-7, 2003
                                                                                  23. Idrissova ZhR et al: Acute disseminated encephalomyelitis in children: clinical features and HLA-DR linkage. Eur J Neurol. 10(5):537-46, 2003
                                                                                  24. Miravalle A et al: Encephalitis complicating smallpox vaccination. Arch Neurol. 60(7):925-8, 2003
                                                                                  25. Au WY et al: Acute disseminated encephalomyelitis after para-influenza infection post bone marrow transplantation. Leuk Lymphoma. 43(2):455-7, 2002
                                                                                  26. Inglese M et al: Magnetization transfer and diffusion tensor MR imaging of acute disseminated encephalomyelitis. AJNR Am J Neuroradiol. 23(2):267-72, 2002
                                                                                  27. Khong PL et al: Childhood acute disseminated encephalomyelitis: the role of brain and spinal cord MRI. Pediatr Radiol. 32(1):59-66, 2002
                                                                                  28. Murthy SN et al: Acute disseminated encephalomyelitis in children. Pediatrics. 110(2 Pt 1):e21, 2002
                                                                                  29. Arya SC: Acute disseminated encephalomyelitis associated with poliomyelitis vaccine. Pediatr Neurol. 24(4):325, 2001
                                                                                  30. Bastianello S: Magnetic resonance imaging of MS-like disease. Neurol Sci. 22 Suppl 2:S103-7, 2001
                                                                                  31. Lin WC et al: Sequential MR studies of a patient with white matter disease presenting psychotic symptoms: ADEM versus single-episode MS. Kaohsiung J Med Sci. 17(3):161-6, 2001
                                                                                  32. Miyazawa R et al: Plasmapheresis in fulminant acute disseminated encephalomyelitis. Brain Dev. 23(6):424-6, 2001
                                                                                  33. Singh S et al: Acute disseminated encephalomyelitis and multiple sclerosis: magnetic resonance imaging differentiation. Australas Radiol. 44(4):404-11, 2000
                                                                                  34. Tsuru T et al: Acute disseminated encephalomyelitis after live rubella vaccination. Brain Dev. 22(4):259-61, 2000
                                                                                  35. Murthy JM et al: Clinical, electrophysiological and magnetic resonance imaging study of acute disseminated encephalomyelitis. J Assoc Physicians India. 47(3):280-3, 1999
                                                                                  36. Pradhan S et al: Intravenous immunoglobulin therapy in acute disseminated encephalomyelitis. J Neurol Sci. 165(1):56-61, 1999
                                                                                  37. Murthy JM: MRI in acute disseminated encephalomyelitis following Semple antirabies vaccine. Neuroradiology. 40(7):420-3, 1998
                                                                                  38. Kumada S et al: Encephalomyelitis subsequent to mycoplasma infection with elevated serum anti-Gal C antibody. Pediatr Neurol. 16(3):241-4, 1997
                                                                                  39. Patel SP et al: Neuropsychiatric features of acute disseminated encephalomyelitis: a review. J Neuropsychiatry Clin Neurosci. 9(4):534-40, 1997
                                                                                  40. Kinoshita A et al: Inflammatory demyelinating polyradiculitis in a patient with acute disseminated encephalomyelitis (ADEM). J Neurol Neurosurg Psychiatry. 60(1):87-90, 1996
                                                                                  41. Kleiman M et al: Acute disseminated encephalomyelitis: response to intravenous immunoglobulin. J Child Neurol. 10(6):481-3, 1995
                                                                                  42. Baum PA et al: Deep gray matter involvement in children with acute disseminated encephalomyelitis. AJNR Am J Neuroradiol. 15(7):1275-83, 1994