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Acute disseminated encephalomyelitis

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Current Treatment Options in Neurology Aims and scope Submit manuscript

Opinion statement

  • •There is no standard therapy for acute disseminated encephalomyelitis (ADEM), and treatments are based on the analogy of the pathogenesis of ADEM with that of multiple sclerosis (MS), namely an inflammatory perivenular demyelination.

  • •High-dose intravenous corticosteroids, such as methylprednisolone, at a dosage standard for MS relapses have been commonly used.

  • •Plasmapheresis, beginning with a course of four to six plasma exchanges, has also been used, particularly when intravenous methylprednisolone has failed.

  • •Intravenous immunoglobulin is a third potential therapeutic modality.

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References and Recommended Reading

  1. Tselis A, Lisak RP: Acute disseminated encephalomyelitis. In Clinical Neuroimmunology. Edited by Antel JP, Birnbaum G, Hartung H-P. London: Blackwell; 1997. A very comprehensive review of the disease.

    Google Scholar 

  2. Tselis A, Lisak RP: Acute disseminated encephalomyelitis and isolated central nervous system demyelinative syndromes. Curr Opin Neurol 1995, 8:227–229.

    Article  PubMed  CAS  Google Scholar 

  3. Pasternak JF, Devivo DC, Prensky AL: Steroid-responsive encephalomyelitis in childhood. Neurology 1980, 30:481–486.

    PubMed  CAS  Google Scholar 

  4. Ziegler DK: Acute disseminated encephalomyelitis: some therapeutic and diagnostic considerations. Arch Neurol 1966, 14:476–488.

    PubMed  CAS  Google Scholar 

  5. Byers RK: Acute hemorrhagic leukoencephalitis: report of 3 cases and a review of the literature. Pediatrics 1975, 56:727–735.

    PubMed  CAS  Google Scholar 

  6. Seales D, Greer M: Acute hemorrhagic leukoencephalitis: a successful recovery. Arch Neurol 1991, 48:1086–1088.

    PubMed  CAS  Google Scholar 

  7. Optic Neuritis Study Group: A randomized, controlled trial of corticosteroids in the treatment of optic neuritis. N Engl J Med 1992, 326:581–588.

    Article  Google Scholar 

  8. Stricker RB, Miller R, Kiprov DD: Role of plasmapheresis in acute disseminated (postinfectious) encephalomyelitis. J Clin Apheresis 1992, 7:173–179.

    Article  PubMed  CAS  Google Scholar 

  9. Newton R: Plasma exchange in acute post-infectious demyelination. Dev Med Child Neurol 1981, 23:538–543.

    Article  PubMed  CAS  Google Scholar 

  10. Cotter F, Bainbridge D, Newland A: Neurological deficit associated with Mycoplasma pneumoniae reversed by plasma exchange. BMJ 1983, 286:22.

    Article  PubMed  CAS  Google Scholar 

  11. Kanter DS, Horensky D, Sperling RA, et al.: Plasmapheresis in fulminant acute disseminated encephalomyelitis. Neurology 1995, 45:824–827.

    PubMed  CAS  Google Scholar 

  12. Dodick DW, Silber MH, Noseworthy JH, et al.: Acute disseminated encephalomyelitis after accidental injection of a hog vaccine: successful treatment with plasmapheresis. Mayo Clin Proc 1998, 73:1193–1195.

    PubMed  CAS  Google Scholar 

  13. Shah AK, Tselis A, Mason B: Acute disseminated encephalomyelitis in a pregnant woman successfully treated with plasmapheresis. J Neurol Sci 2000, 174:147–151.

    Article  PubMed  CAS  Google Scholar 

  14. Weinshenker BG, O’Brien PC, Petterson TM, et al.: A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease. Neurology 1999, 46:878–886. The first randomized controlled trial of plasmapheresis in demyelinating diseases of the central nervous system suggesting efficacy in cases in which corticosteroids are ineffective.

    CAS  Google Scholar 

  15. Kleiman M, Brunquell P: Acute disseminated encephalomyelitis: response to intravenous immunoglobulin. J Child Neurol 1995, 10:481–483.

    PubMed  CAS  Google Scholar 

  16. Hahn JS, Siegler DJ, Enzmann D: Intravenous gamma globulin therapy in recurrent acute disseminated encephalomyelitis. Neurology 1996, 46:1173–1174.

    PubMed  CAS  Google Scholar 

  17. Pradhan S, Gupta RP, Shashank S, Panday N: Intravenous immunoglobulin therapy in acute disseminated encephalomyelitis. J Neurol Sci 1999, 165:56–61.

    Article  PubMed  CAS  Google Scholar 

  18. Straussberg R, Schonfeld T, Weitz R, et al.: Improvement of atypical acute disseminated encephalomyelitis with steroids and intravenous immunoglobulins. Pediatr Neurol 2001, 24:139–143.

    Article  PubMed  CAS  Google Scholar 

  19. Schwab S, Junger E, Spranger M, et al.: Craniectomy: an aggressive treatment approach in severe encephalitis. Neurology 1997, 48:412–417.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, Wayne State University Detroit Medical Center, 4201 Saint Antoine Street, UHC-8D, 48201, Detroit, MI, USA

    Alexandros Tselis MD, PhD

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  1. Alexandros Tselis MD, PhD
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Tselis, A. Acute disseminated encephalomyelitis. Curr Treat Options Neurol 3, 537–542 (2001). https://doi.org/10.1007/s11940-001-0016-7

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  • DOI: https://doi.org/10.1007/s11940-001-0016-7

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