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ADEM — RACP Paediatrics MCQ

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ModerateNeurologyADEMRACP Paediatrics

A 6-year-old develops encephalopathy, bilateral optic neuritis, and multifocal neurological deficits 10 days after a viral illness. MRI shows widespread white matter lesions in both hemispheres, brainstem, and spinal cord. What is the most likely diagnosis?

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Correct answer: D — Acute disseminated encephalomyelitis (ADEM)

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating disorder of the CNS that typically follows a viral illness or vaccination. It presents with encephalopathy (required for diagnosis) plus multifocal neurological deficits and widespread white matter lesions on MRI. Treatment is high-dose IV methylprednisolone.

Reference: RCH Melbourne – 2023 – Encephalitis CPG; RACP Paediatric Curriculum – Neurology