Acute Disseminated Encephalomyelitis (ADEM) | Symptoms & Causes

What are the symptoms of acute disseminated encephalomyelitis?

The symptoms of acute disseminated encephalomyelitis (ADEM) come on quickly. Your child may feel tired or irritable at first. It is also common to have a viral illness with fever a few days to a few weeks before the beginning of the symptoms. Other symptoms may include:
  • nausea and vomiting
  • headache
  • confusion
  • weakness
  • ataxia (unsteady walk)
  • sensory changes, including numbness or tingling
  • optic neuritis (trouble with vision)
  • seizures

The location of the inflammation (swelling) within the brain and spinal cord determines what symptoms occur.

What causes ADEM?

In ADEM, the immune system reacts against the brain and spinal cord. Autoimmunity is not contagious, but may be genetic (inherited from parents). ADEM may also follow a vaccination, although this is rare. In some cases of ADEM, a specific trigger/cause cannot be identified.

Is ADEM similar to multiple sclerosis (MS)?

Both ADEM and MS involve autoimmune responses to myelin in the brain and spinal cord. They are both "demyelinating" disorders. Symptoms common to both disorders include loss of vision, weakness, numbness and loss of balance. Corticosteroids are used to treat attacks of ADEM and MS.

In most cases, ADEM occurs only once, while patients with MS have further, repeated attacks of inflammation in their brains and spinal cords. Although children can develop MS, it is much more common in adults, whereas ADEM is more common in children. Typical symptoms of ADEM such as feverheadache and confusion, are not usually seen in people with MS. MRIs are helpful when distinguishing ADEM from MS. Most children with MS are treated with ongoing medication to prevent attacks. Patients with ADEM do not require such medication.

Although it is uncommon, children who have ADEM can later develop MS. Therefore, it is important to have ongoing follow up with your our team. Let your doctor know immediately if you notice new symptoms in your child, such as:
  • visual loss
  • weakness
  • numbness
  • loss of balance