ContentsSynopsisCodesDifferential Diagnosis & PitfallsBest TestsReferencesView all Images (2)
Acute demyelinating encephalomyelitis
Other Resources UpToDate PubMed

Acute demyelinating encephalomyelitis

Print Images (2)
Contributors: Christine Osborne MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed


Acute disseminated encephalomyelitis (ADEM) is an often rapidly progressive autoimmune inflammatory demyelinating disease of the central nervous system that may be triggered by infections or immunizations. It is a rare disease and is more common in children than adults. Patients typically present with rapid onset of neurologic symptoms following an incubation period of several days to 2 months, with deterioration requiring hospitalization. Common symptoms include headache, fever, nausea, vomiting, altered mental status ranging from confusion and irritability to coma, and motor deficits (paraparesis or tetraparesis) with sensory deficits. Patients often have brainstem involvement with dysarthria and oculomotor deficits.

The most common triggers, when identified, are viral or bacterial infections including rubeola, rubella, mumps, varicella, Epstein-Barr virus, human herpesvirus 6, influenza, human immunodeficiency virus, and Mycoplasma pneumoniae. Several cases of ADEM following rabies vaccination have been reported. There have been reports of ADEM following Zika virus infection.

Consider the diagnosis in patients with acute multifocal neurologic deficits, possibly with a recent history of illness or vaccination, without previously unexplained neurologic deficits.


G04.00 – Acute disseminated encephalitis and encephalomyelitis, unspecified

83942000 – Acute disseminated encephalomyelitis

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required


Subscription Required

Last Updated: 04/13/2016
Copyright © 2018 VisualDx®. All rights reserved.
Acute demyelinating encephalomyelitis
Print 2 Images
View all Images (2)
(with subscription)
Acute demyelinating encephalomyelitis (Initial Presentation) : Fever, Headache, Vomiting, Delirium, Irritability, Drowsiness, Meningism
Copyright © 2018 VisualDx®. All rights reserved.