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No specific autoantibody is diagnostic
In some cases, anti-MOG antibodies may be found (linked to recurrent forms)
Acute Disseminated Encephalomyelitis (ADEM) is a rare autoimmune condition that causes sudden inflammation in the brain and spinal cord. It typically follows a viral or bacterial infection (or sometimes a vaccination), and leads to damage of the protective myelin covering on nerve fibers, which disrupts nerve signals.
ADEM is more common in children and young adults, and usually occurs only once (unlike multiple sclerosis, which is recurrent).
Sudden fever, headache, and confusion
Drowsiness or lethargy
Seizures (in some cases)
Weakness or numbness (often on one side)
Vision problems (blurred vision, eye pain, or double vision)
Balance issues or trouble walking
Speech difficulties
Coma (in severe cases)
Symptoms often develop rapidly over a few days.
ADEM is believed to be triggered by an immune system overreaction, usually after:
Viral infections (e.g., measles, flu, COVID-19, Epstein-Barr)
Bacterial infections (rarely)
Vaccinations (very rare, e.g., rabies, measles, influenza)
The immune system, in fighting the infection, mistakenly attacks myelin in the central nervous system.
There’s no single test for ADEM, so doctors rely on:
MRI scans – to show inflammation and demyelination in the brain/spinal cord
Lumbar puncture (spinal tap) – to check cerebrospinal fluid for inflammation
Blood tests – to rule out infections or other autoimmune diseases
Sometimes EEG (to detect abnormal brain activity)
Doctors also rule out other conditions like multiple sclerosis or autoimmune encephalitis.
High-dose corticosteroids (like IV methylprednisolone) are the first line of treatment to reduce inflammation
If steroids don’t help:
IVIG (intravenous immunoglobulin)
Plasmapheresis (plasma exchange)
Supportive care (rehab, physical therapy, seizure control)
Most people recover fully, especially with early treatment
Some may have lingering symptoms (fatigue, concentration issues, or weakness)
Rarely, ADEM can be fatal or evolve into multiphasic ADEM or MS
Prognosis is generally better in children than in adults.
Estimated 0.4 to 0.8 per 100,000 people per year
More common in children under age 10
Slightly more common in boys
National Institute of Neurological Disorders and Stroke (NINDS). (2023). Acute Disseminated Encephalomyelitis.
https://www.ninds.nih.gov/disorders/all-disorders/acute-disseminated-encephalomyelitis
Mayo Clinic. (2023). ADEM Overview.
https://www.mayoclinic.org/
Pohl, D., et al. (2016). Acute disseminated encephalomyelitis: Updates on an inflammatory CNS syndrome. Neurology: Clinical Practice, 6(2), 163–172.
Krupp, L. B., et al. (2013). Diagnostic criteria for pediatric ADEM. Neurology, 80(16), 1401–1407.
https://doi.org/10.1212/WNL.0b013e31828c2fdd
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