aka acute demyelinating encephalomyelitis
a rare autoimmune disease (8 per 1,000,000 people per year) marked by a sudden, widespread attack of inflammation in the brain and spinal cord
produces multiple inflammatory lesions in the brain and spinal cord, particularly in the white matter
it may be one of the possible clinical causes of anti-MOG associated encephalomyelitis
unlike MS, ADEM is usually a single event which usually causes decreased conscious state, coma and death (in 5-10%) and occurs usually in children although adolescents and adults can get the disease too
occurs in all ages, most reported cases are in children and adolescents, with the average age around 5 to 8 years old
adults may have a fulminant course
with aggressive Rx, full recovery is seen in 50 to 75% of cases with increase in survival rates up to 70 to 90% with figures including minor residual disability as well
average time to recover from ADEM flare-ups is one to six months
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the only proven vaccine is the Semple form of the rabies vaccine but many other vaccines have been associated with it but at a case study level only
risk of developing ADEM from an actual measles infection, is about 1 per 1,000 cases whereas risk of ADEM from measles vaccination is 1 per 100,000
symptoms usually begin 1–3 weeks after infection (or vaccination)
may have fever, headache, nausea and vomiting, confusion, vision impairment, drowsiness, seizures, coma
generally have UMN lesion clinical features and may have hemiparesis, paraparesis, cranial nerve palsies and peripheral neuropathy
neurologic features rapidly progress over the course of hours to days