ACUTE DISSEMINATED ENCEPHALOMYELITIS (ADEM) is an ACUTE, inflammatory, monophasic, demyelinating and immune-mediated disorder of central nervous system; occurs mostly in children after systemic viral infections or vaccinations. ACUTE polysymptomatic neurologic signs such as encephalopathy, paralysis of limbs, cranial nerve involvement, ataxia and optic neuritis are common manifestations. Brain magnetic resonance imaging study is essential for diagnosis and enabling prompt diagnosis and treatment. Evidence of multifocal lesions of demyelination in subcortical white matter are seen. They are usually bilateral and asymmetrical. Treatment optins have included steroids, immunoglobulins, and plasmapheresis. ADEM is treatable and prognosis is good.

The ACUTE DISSEMINATED ENCEPHALOMYELITIS is a rare, monophasic or multi-phasic dismyelinating disease, which affects the central nervous system and that appears shortly after either a exanthematous, non-exanthematous or vaccination. It attacks mainly children and young adults. The prognosis is usually favorable but sequelae are possible. The common therapeutic approach is the use of corticosteroids. Intravenous immunoglobulin (IVIg) has been proposed for relapses, and plasmapheresis for fulminant cases the cause of ADEM is unknown. The diagnosis is based on clinical picture, supported by radiology and laboratory tests.This 24-month-old boy was admitted with fever, vomiting and intermittent irritability preceded by a herpetic gingivostomatitis 10 days earlier. Growth and development were normal. Brain MRI at that time revealed multiple asymmetric, hyperintense and patchy white matter lesions of variable size on T2- weighted images. CSF examination revealed no cells, normal protein and glucose levels, normal IgG index and no oligoclonal bands. Gram’s and Wright’s stains and screening for viral antibodies were negative. Electroencephalography (EEG) was normal. He was started on Intrvenous immunoglobulin (400 mg/kg) intravenously for 5 days. At the end of the treatment he was afebrile with good general condition.

ACUTE DISSEMINATED ENCEPHALOMYELITIS (ADEM) is a monophasic clinical syndrome, characterized by immune-mediated demyelination of central nervous system neurons, which yield extensive damage in the brain and spinal cord. It usually affects children and young adults following infections or immunization. Here we describe a 9-year-old Fars female presented with ACUTE onset of psychotic disorder, one week after an upper respiratory infection. Magnetic resonance images (MRI) of the brain were consistent with the diagnosis of the ACUTE DISSEMINATED ENCEPHALOMYELITIS (ADEM). ADEM is one of the differential diagnoses to be considered when an ACUTE psychotic disorder arises during childhood especially as post vaccination or infection.

This article reports on an 5-month-old infant who was admitted to our hospital for prolonged fever, focal status epileptics and encephalopathy. Brain magnetic resonance imaging (MRI) demonstrated a single hyperintense lesion in right putamen in T2-weighted images. A diagnosis of ACUTE DISSEMINATED ENCEPHALOMYELITIS was made based on the clinical features, treatment response and clinical course. An executive literature review revealed a few cases under the age of one year. This patient is the youngest are who is reported from Iran.

ACUTE DISSEMINATED ENCEPHALOMYELITIS (ADEM) is an inflammatory disease that causes demyelination and affects the white matter of the brain and spinal cord through an immune response. The patient, an eight-year-old Iranian Kurdish boy with a height of 125 cm and a weight of 24 kg, complained from fever for three days which didn’, t respond to acetaminophen medication. After three days, the symptoms developed into headache, vomiting, and decreased consciousness. The patient was admitted to the emergency department of Imam Hasan hospital in Bojnourd, Iran, in July 2019. LP diagnostic testing, Wright Agglutination test, Brain CT, and MRI examination were performed. Finally, a diagnosis of ACUTE DISSEMINATED ENCEPHALOMYELITIS (ADEM) was confirmed. Following the ADEM diagnosis, methylprednisolone 500 mg was administered immediately and continued for five days. This case study suggests that MRI is the most effective method of diagnosis for ADEM, and high-dose methylprednisolone is the treatment of choice for this syndrome.