What is the eitiology of ADEM?
Immune mediated cross-reactivity to viral antgens.
What are the 4 readily distinguishing features suggesting a diagnosis of ADEM rather that MS in the acute setting?
(i) Age of patient younger than 12 years; (ii) History of preceding illness or recenet immunisation; (iii) Fever; (iv) Mental state changes and seizures.
What is the mainstay of treatment and management of ADEM?
High dose IV corticosteroid therapy.
In which patient group is the fulminant form of ADEM most likely to affect?
Patients less than 2 years old.
There are widespread areas of T2 hyperintense signal abnormality involving the subcortical white matter in the parasagittal medial parietal lobes, left temporal operculum and occipital subcortical white matter. Further deep grey matter involvement in both thalami is noted along with diffuse pontine signal alteration with extension into the cerebellar peduncles.
There is patchy diffusion restriction around the margin of particularly the left temporal focus.
There is no pathological intracranial enhancement following contrast administration.