Acute disseminated encephalomyelitis
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Acute disseminated encephalomyelitis, abbreviated ADEM, is an uncommon neuropathology with some similarities with multiple sclerosis.
General
- Thought to be autoimmune; often associated with/preceded by viral illness.[1]
- May mimic multiple sclerosis.
Treatment:
- Steroids.
- Plasmapheresis.
Diagnosis:
- Need to r/o infection (with lumbar puncture).
- No old plaques on imaging (MRI).
An acute form exists known as acute hemorrhagic leukoencephalitis[2] (AKA acute necrotizing hemorrhagic encephalomyelitis).
Microscopic
Features:[3]
- Myelin loss with sparing of axons.
- Inflammation:
- Early: neutrophils.
- Late: mononuclear cells (lymphocytes, plasma cells).
- Lipid-laden macrophages.
DDx:
- Multiple sclerosis.
- Tend to be larger, more lymphocytes,[4] age of the lesions differ.
- Acute necrotizing hemorrhagic encephalomyelitis (ANHE) - if one considers this a separate entity.
- Acute necrotizing encephalopathy.[5]
See also
References
- ↑ Tenembaum S, Chitnis T, Ness J, Hahn JS (April 2007). "Acute disseminated encephalomyelitis". Neurology 68 (16 Suppl 2): S23–36. doi:10.1212/01.wnl.0000259404.51352.7f. PMID 17438235.
- ↑ URL: http://path.upmc.edu/cases/case102/dx.html. Accessed on: 2 January 2012.
- ↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1312. ISBN 978-1416031215.
- ↑ Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 423. ISBN 978-1416025887.
- ↑ URL: http://path.upmc.edu/cases/case619/dx.html. Accessed on: 26 January 2012.