Callen MS-ADEM criteria

Last revised by Patrick J Rock on 14 Sep 2020

The Callen MS-ADEM criteria can be useful in differentiating between acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) in children, as the first attack of immune-mediated demyelination is a frequent diagnostic challenge.

Given the diagnostic challenge, several diagnostic criteria may be used to differentiate, e.g. Barkhof criteria, KIDMUS criteria, Callen MS-ADEM criteria, Callen diagnostic MS criteria. A 2010 study compared these different criteria, with the Callen MS-ADEM criteria 1 showing the best combination of sensitivity (75%) and specificity (95%) 2.


The proposed criteria can only be applied to distinguish children with the clinical presentation of ADEM from that of a first MS attack.

At least two out of the three following criteria should be fulfilled for MS diagnosis:

  • absence of a diffuse bilateral lesion pattern
  • presence of black holes
  • two periventricular lesions ​

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