ADEM
ADEM INTRODUCTION ADEM is an inflammatory, demyelinating event of early childhood presenting with an acute onset of polyfocal neurologic deficits, accompanied by encephalopathy and changes compatible with demyelination on brain MRI Epidemiology Although ADEM can occur at any age, most series reporta mean age of between 5 and 8 yr with a slight male predominance. The reported incidence ranges from 0.1-0.6 per 100,000 per year in the pediatric population. ADEM is usualy monophasic, but recurrence can occur; if the recurrence is 3 mo or longer after the first episode, the condition is termed multiphasic disseminated encephalomyelitis (MDEM). Up to 50% of cases of ADEM have been found to be associated with MOG-Ab (Myelin oligodendrocyte glycoprotien) positivity in the serum, and almost all cases of MDEM are MOG-Ab positive; there is thus a strong likelihood that as MOG-Ab testing becomes more available, cases of non-MOGAb positive MDEM will become exceptionally rare. An episode of ADEM can...