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Acute disseminated encephalomyelitis (view source)
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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.<ref name=pmid17438235>{{cite journal |author=Tenembaum S, Chitnis T, Ness J, Hahn JS |title=Acute disseminated encephalomyelitis |journal=Neurology |volume=68 |issue=16 Suppl 2 |pages=S23–36 |year=2007 |month=April |pmid=17438235 |doi=10.1212/01.wnl.0000259404.51352.7f |url=}}</ref> | |||
*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''<ref>URL: [http://path.upmc.edu/cases/case102/dx.html http://path.upmc.edu/cases/case102/dx.html]. Accessed on: 2 January 2012.</ref> (AKA ''acute necrotizing hemorrhagic encephalomyelitis''). | |||
==Microscopic== | |||
Features:<ref>{{Ref PBoD8|1312}}</ref> | |||
*Myelin loss with sparing of axons. | |||
*Inflammation: | |||
**Early: [[neutrophil]]s. | |||
**Late: mononuclear cells (lymphocytes, plasma cells). | |||
*Lipid-laden macrophages. | |||
DDx: | |||
*[[Multiple sclerosis]]. | |||
**Tend to be larger, more lymphocytes,<ref>{{Ref APBR|423}}</ref> age of the lesions differ. | |||
*Acute necrotizing hemorrhagic encephalomyelitis (ANHE) - if one considers this a separate entity. | |||
*Acute necrotizing encephalopathy.<ref>URL: [http://path.upmc.edu/cases/case619/dx.html http://path.upmc.edu/cases/case619/dx.html]. Accessed on: 26 January 2012.</ref> | |||
==See also== | |||
*[[Neuropathology]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Neuropathology]] | |||