Acute Disseminated Encephalomyelitis

ADEM is an immune-mediated demyelinating disorder of the central nervous system, typically occurring after infections or vaccinations. Patients present acutely with multifocal neurological deficits, such as hemiparesis, ataxia, optic neuritis, and altered consciousness. MRI demonstrates diffuse, often bilateral white matter lesions, sometimes affecting the brainstem, cerebellum, or spinal cord. High-dose intravenous corticosteroids constitute first-line therapy, with intravenous immunoglobulin or plasma exchange reserved for refractory cases. Prognosis is generally favorable with early intervention, though some patients may develop residual neurological deficits.