A case of acute disseminated encephalomyelitis (ADEM)

Saba Nemati-Ahmadabad,Sheida Shaafi,Seyedpouya Paknezhad,Mahboob Pouraghaei

doi:10.15171/jarcm.2019.018

Abstract

Introduction: Acute disseminated encephalomyelitis (ADEM) is an uncommon monophasic idiopathic inflammatory demyelinating disease. ADEM typically presents with non-specific symptoms including nausea, vomiting, fever, and headache. This then progresses to neurological deficits such as motor weakness, altered sensorium, and often significant morbidity or mortality. Typically, the infectious insult is thought to be in transient viral infection or vaccination. Case Report: We describe a case of ADEM in a 15-year-old girl that came to emergency department with dizziness and general weakness; she was unable to speak, and lethargic, with no positive past history. Her laboratory tests and spiral brain computed tomography (CT) scan were normal. She was admitted to neurology ward, and threated with high-dose corticosteroids. Our patient responded well to corticosteroids. Conclusion: In patients with neurologic deficits in emergency department, the physician must think about ADEM although it is rare.

Highlights

We describe a case of Acute disseminated encephalomyelitis (ADEM) in a 15-year-old girl that came to emergency department with dizziness and general weakness; she was unable to speak, and lethargic, with no positive past history
ADEM is a rare disease with an estimated annual incidence rate of 8 per 1000000.2 It presents as an autoimmune demyelinating disease of the central nervous system (CNS) triggered by a recent infections process in most but not all cases.[3]
It is proposed to occur due to myelin autoantigens sharing antigens with those of an inciting pathogen.[4]. These infectious antibodies crossreact with myelin autoantigens, and result in diffuse encephalomyelitis.[4,5]

Summary

Introduction

We describe a case of ADEM in a 15-year-old girl that came to emergency department with dizziness and general weakness; she was unable to speak, and lethargic, with no positive past history. Her laboratory tests and spiral brain computed tomography (CT) scan were normal. In patients with neurologic deficits in emergency department, the physician must think about ADEM it is rare.

Results

Conclusion