Acute Disseminated Encephalomyelitis

Acute disseminated encephalomyelitis (ADEM) is a neurological disorder that causes a short and sudden inflammatory attack in the brain and spinal cord. This attack damages the myelin sheath — the fatty tissue that protects nerve cells in the same way that insulation protects electrical wiring in a house. Myelin also helps nerve fibers conduct electrical impulses to and from the brain. Conditions that cause damage to the myelin sheath are called demyelinating disorders.

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ADEM is the most common demyelinating disorder in children. The condition may occur after a child has a viral infection or after vaccination for measles, mumps or rubella, though in some cases, there's no preceding cause. The prognosis for children who develop ADEM varies. In many cases, with proper treatment, recovery begins within days of the attack.

Our Regional Pediatric Multiple Sclerosis Center specializes in the care of children and adolescents with ADEM and related demyelinating diseases.

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Symptoms of acute disseminated encephalomyelitis, or ADEM, are similar to those of multiple sclerosis (MS). As a result, the disease is often misdiagnosed as a severe attack of MS. There are key differences, however, between the symptoms of ADEM and MS, which can be recognized by a neurologist.

Initial symptoms of ADEM occur quickly and intensely as a single, short-lived attack, though some children have recurrent episodes over a period of months. Symptoms may include:

  • Fatigue
  • Fever
  • Headache
  • Nausea
  • Vomiting

Changes in your child's consciousness — such as seizures or, in severe cases, coma — as well as behavioral changes such as irritability are also likely.

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An accurate and early diagnosis of acute disseminated encephalomyelitis, or ADEM, is critical in the management of your child's disease and quality of life.

In making a diagnosis, your child's doctor will first conduct a thorough physical examination, asking about your child's symptoms, including when they started and how they've eased or progressed over time. Your child's doctor will also record a full medical history, including information about your immediate and extended family.

Next, a series of tests will be conducted, including magnetic resonance imaging (MRI) of the brain and spinal cord to look for lesions, or areas of damage that may indicate ADEM and rule out other disorders such as multiple sclerosis. An MRI scan is a noninvasive procedure that uses powerful magnets to construct clear, detailed pictures of the brain and spinal cord tissues.

Recent brain lesions are more typical in ADEM, but can also occur in multiple sclerosis.

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Children and adolescents with acute disseminated encephalomyelitis or ADEM receive treatment at our Pediatric Multiple Sclerosis Center. Our experts specialize in ADEM and related diseases and work with each child to develop a unique treatment plan, including long-term follow-up care specifically tailored to his or her needs.

When necessary, we collaborate with other specialists at UCSF or elsewhere to make sure your child receives the most comprehensive care possible. Because we are part of an international network of pediatric MS centers sponsored by the National Multiple Sclerosis Society, we have access to the latest information, research and treatments.

Most children with ADEM will respond partially or completely to corticosteroid therapy, which diminishes symptoms by suppressing inflammation in the brain and spinal cord.

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Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Pediatric Brain Center

Multiple Sclerosis Center
1825 Fourth St., Fifth Floor, 5A
San Francisco, CA 94158
Phone: (415) 353-3939
Fax: (415) 353-3543
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