Question

Acute disseminated encephalomyelitis (ADEM): Clinical presentation.

Hint:

ADEM can mimic other neurological conditions, so it is important to consider recent infections or vaccinations in the history.

Answer 1

Step 1: Clinical Presentation of ADEM.
Acute disseminated encephalomyelitis (ADEM) is a rare, autoimmune, inflammatory demyelinating disorder of the central nervous system, often following a viral infection or vaccination. The clinical presentation includes:
(1) Acute Onset of Neurological Symptoms: The disease typically presents with rapid onset of symptoms, often days to weeks following an infection or vaccination.
(2) Fever: Commonly seen at the onset of the illness.
(3) Neurological Deficits: These include confusion, irritability, headache, and altered consciousness.
(4) Motor Symptoms: Hemiparesis, quadriparesis, and ataxia are common.
(5) Visual Disturbances: Blurred vision or optic neuritis can occur.
(6) Seizures: These may develop, particularly in more severe cases.
(7) Cerebellar Signs: Ataxia and dysmetria are common, especially in children.