Acute Disseminated Encephalomyelitis
DOI:
https://doi.org/10.61788/njn.v1i20.03Keywords:
acute disseminated encephalomyelitis (ADEM), multiple sclerosis, infection, central nervous system, autoimmune pathology, MRI criteria, glucocorticoids, IVIGAbstract
This study examines the new literature on acute disseminated encephalomyelitis (ADEM) or post- infectious encephalomyelitis (encephalomyelitis that develops after infection), and evidence- based information has been collected by studying its epidemiology, etiological causes, clinical course, diagnostic criteria, and management. Mainly people with ADEM genetic susceptibility are thought to have autoimmune disorders of the central nervous system as a result of environmental influences (infectious and non-infectious factors). MRI has been shown to be the most optimal neuroimaging method in the diagnosis of ADEM. One important point is that the features found on MRI of the brain can also help differentiate ADEM from multiple sclerosis. However, it is described that it is not possible to completely differentiate between the two diseases on the basis of MRI alone. In addition, Gadolinium contrast media (sometimes called a MRI contrast media, agents or ‘dyes’) and non-contrast MRI imaging of the brain once a year for several years in patients with ADEM and asymptomatic is recommended because it is important to rule out pathological lesions as well as multiple sclerosis. Obtaining cerebrospinal fluid (lumbar puncture) has not lost its relevance in ADEM, but it has been found that its sensitivity is not high due to the different results. In addition to multiple sclerosis, information was analyzed on criteria important in the differential diagnosis of infectious meningoencephalitis, sarcoidosis, vasculitis, progressive multifocal leukoencephalopathy (PML), and Behcet's syndrome. Because immune suppression is important in the treatment of ADEM, high-dose glucocorticoids are the basis of pharmacological therapy. It has been established that IVIG (Intravenous Immunoglobulin) and plasmapheresis can be used if treatment is not effective within 5 days. According to statistics, the prognosis of ADEM varied depending on age, clinical manifestations and course of the disease.
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