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ADEM — RACP Paediatrics MCQ

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ModerateNeurology & DevelopmentADEMRACP Paediatrics

A 4-year-old presents with an acute encephalopathy 2 weeks after a viral illness. MRI shows multifocal white matter lesions with enhancement. CSF shows lymphocytic pleocytosis. What is the most likely diagnosis?

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Correct answer: E — Acute disseminated encephalomyelitis (ADEM)

ADEM is a post-infectious inflammatory demyelinating disorder presenting with encephalopathy plus multifocal neurological deficits. MRI shows large, poorly-defined white matter lesions. Most children make a good recovery with IV methylprednisolone. If relapsing, MOG antibody disease or MS should be considered.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: ADEM