The diagnosis ADEM should be readily considered whenever there is a close temporal relation between an infection or a vaccination and the subacute, onset of neurological deficits attributable to the CNS. The most widely applied diagnostic tool is brain magnetic resonance imaging (MRI). It is worthwhile performing imaging of the spinal cord too. If MRI brain findings are normal, consider another diagnosis.
Most children recover well from their ADEM event, although mild cognitive sequelae become evident as the child matures. Some of them can have a subsequent relapsing remitting Multiple Sclerosis disease course.
A number of various anti-inflammatory and immuno-supressant therapies may potentially be effective such as IV methylprednisolone, IVIG, plasmapharesis, cyclophosphamide, etc.
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