Acute Disseminated Encephalomyelitis (ADEM)

What is acute disseminated encephalomyelitis?

Acute disseminated encephalomyelitis (ADEM) involves a brief but intense attack of inflammation (swelling) in the brain and spinal cord that damages the brain's myelin. Myelin is the protective covering of nerve fibers. Myelin is also called white matter due to its color. Because ADEM affects myelin, it is a type of a "demyelinating" disorder.

ADEM is an "autoimmune" condition that often occurs after a child has an infection, such as a cold. The immune system protects the body from invaders, like bacteria and viruses. Autoimmune diseases confuse the body's immune system. Instead of fighting against bacteria or viruses, it attacks healthy cells and tissues.

Although ADEM can occur at any age, children are more likely than adults to have it. Most children make a complete or nearly complete recovery. The main medication for treating ADEM is a type of steroid. Most children tolerate the medication very well.

In approximately 80 percent of children, ADEM occurs only once. In some patients, it can re-occur. When it does, symptoms can be identical to the child's initial episode, but they can also be different.

It is not known why children develop ADEM with certain infections at certain times. If you notice symptoms during an infection that you think are unusual, such as confusion, changes in vision, weakness, numbness or imbalance, it is important to notify your child's doctor immediately.

How we care for ADEM

Boston Children's Hospital treats ADEM at the Pediatric Multiple Sclerosis and Related Disorders Program. Our program includes a pediatric neuropsychologist, a nurse and a social worker.