Acute disseminated encephalomyelitis: Difference between revisions
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{{SK}} ADEM | {{SK}} ADEM | ||
== Laboratory Findings == | == Laboratory Findings == | ||
Revision as of 20:31, 20 November 2012
| Acute disseminated encephalomyelitis | |
| ICD-10 | G04.0 |
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| ICD-9 | 323.61 |
| DiseasesDB | 158 |
| MeSH | D004673 |
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Acute disseminated encephalomyelitis Microchapters |
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Differentiating Acute disseminated encephalomyelitis from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Acute disseminated encephalomyelitis On the Web |
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American Roentgen Ray Society Images of Acute disseminated encephalomyelitis |
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Directions to Hospitals Treating Acute disseminated encephalomyelitis |
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Risk calculators and risk factors for Acute disseminated encephalomyelitis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: ADEM
Laboratory Findings
Electrolyte and Biomarker Studies
- CSF protein is usually modestly elevated (50-150 mg/dl)
- CSF lymphocytic pleocytosis is present, usually <200 cells/ul.
- Serum white count may be normal or elevated
MRI and CT
- Radiographic features:
- MRI
- Extensive gadolinium enhancement of white matter of the brain and spinal cord
- Often extensive and relatively symmetric, often also involving the posterior fossa
- Most lesions enhance with gadolinium, suggestive that all lesions are active, and that the disease is therefore monophasic.
- CT is less sensitive and is sometimes falsely negative
- MRI
Risk Stratification and Prognosis
- Prognosis varies with the severity of the neurologic disease. Some patients will not survive the acute illness, and some will be left with neurologic sequelae. Some remarkably recover completely.
- The disease is characteristically monophasic, but descriptions of multiphasic disease have been reported.
- Affected children will often suffer from persistent seizures and behavioral and learning disorders. Adults are somewhat less likely than children to have neurologic sequelae.
Treatment
- There are case reports of improvement with treatment with plasma exhange and intravenous immunoglobulin in patients who have not responded to steroids.
- The first treatment is usually steroids and intensive care is often required.
Pharmacotherapy
Acute Pharmacotherapies
- Most patients are treated with pulse intravenous methylprednisolone with subsequent taper.
Acknowledgements
The content on this page was first contributed by: ELLISON L. SMITH, M.D.
Related Chapters
External links
- Acute Disseminated Encephalomyelitis (ADEM)Information page-> including pathogenesis/aetiology/treatment/prognosis at adem.org
- Acute Disseminated Encephalomyelitis (ADEM) at myelitis.org
- Murthy J (2002). "Acute disseminated encephalomyelitis". Neurology India. 50 (3): 238–43. PMID 12391446.
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Multiple sclerosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Acute disseminated encephalomyelitis On the Web |
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American Roentgen Ray Society Images of Acute disseminated encephalomyelitis |
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Risk calculators and risk factors for Acute disseminated encephalomyelitis |
Template:Diseases of the nervous system
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