What Is The Best Way To Treat Acute Disseminated Encephalomyelitis (ADEM)?

What is Acute Disseminated Encephalomyelitis (ADEM)?

Acute Disseminated Encephalomyelitis, which is commonly referred to as ADEM, is an extremely rare neurological condition affecting the central nervous system(1). Acute Disseminated Encephalomyelitis is characterized by inflammation of the spinal cord and brain or even at times the optic nerves(1, 7). This inflammation also causes significant damage to the myelin sheath, which is the outer covering that protects the nerves from damage caused by injuries or inflammation(1).

What Causes Acute Disseminated Encephalomyelitis?

Acute Disseminated Encephalomyelitis or ADEM is not specific to any age or ethnicity; however, is seen to occur more during the spring and winter months(1). Acute Disseminated Encephalomyelitis usually follows a bacterial or viral illness within a span of two to three weeks after the infection, but is not specific to only bacterial or viral illness(1).

What are the Symptoms of Acute Disseminated Encephalomyelitis (ADEM)?

The primary presenting features of Acute Disseminated Encephalomyelitis or ADEM are high grade fever, persistent headaches, neck stiffness, numbness and tingling along with weakness of the upper or lower extremities, problems maintaining balance, vision problems, articulation problems, dysphagia, problems controlling bladder or bowels(1).

In some rare cases, there may also be seizures or the patient can go into a coma due to complications of Acute Disseminated Encephalomyelitis or ADEM(1). This article discusses about the best ways on how to treat this condition.

What is the Best Way to Treat Acute Disseminated Encephalomyelitis (ADEM)?

Unfortunately, there is no cure for Acute Disseminated Encephalomyelitisor ADEM. Hence the aim of the treatment is to prevent complications and calm down the symptoms(5, 6). The best possible way to treat Acute Disseminated Encephalomyelitis is by calming down the inflammation affecting the central nervous system. Controlling the inflammation of Acute Disseminated Encephalomyelitis can prevent long-term damage to the nerves and myelin sheath within the spinal cord and brain.

The treatment of Acute Disseminated Encephalomyelitis usually starts with high dose corticosteroids, which are intravenously administered for about a week or so(1, 2, 5, 6). This will result in immediate improvement of symptoms of Acute Disseminated Encephalomyelitis. Treatment of Acute Disseminated Encephalomyelitis will then be switched to oral steroids, which will be given for a few weeks, but the dose will gradually be weaned down(2, 5, 6).

If this form of treatment is ineffective or if the patient has significant side effects or if the patient is suffering from severe form of this condition, then a procedure called plasmapheresis is done for treating Acute Disseminated Encephalomyelitis(2, 5, 6). In plasmapheresis, the blood of the patient is filtered out and the offending antibodies are removed and the antibody free blood is filtered back into the body(3).

IVIG is yet another treatment that is given for Acute Disseminated Encephalomyelitis or ADEM(2, 5, 6). In this form of treatment for Acute Disseminated Encephalomyelitis, antibodies from a healthy individual is taken and injected into the patient intravenously(4). Other than this, the treatment for Acute Disseminated Encephalomyelitis is normally symptomatic and supportive(5, 6).

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