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Symptoms and Diagnosis of ADEM

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The location of the inflammation (swelling) within the brain, spinal cord and optic nerves determines what symptoms of acute disseminated encephalomyelitis (ADEM) occur, including:
  • Fever
  • Headache (can be prolonged and severe in children)
  • Nausea and vomiting
  • Neurological changes including
    • Confusion, drowsiness or coma
    • Weakness in the arms or legs
    • Unsteady walk (ataxia)
    • Numbness or tingling (sensory changes)
    • Trouble with vision, often in both eyes (optic neuritis)
    • Seizures
    • Trouble swallowing
The process of diagnosis includes:
  • A medical history including recent history of infection or vaccination
  • A neurological examination with some of the above findings (symptoms)
  • Brain and spinal cord magnetic resonance imaging (MRI) scans
  • A lumbar puncture (spinal tap) to make sure there is no infection in the spinal fluid such as meningitis or encephalitis
  • Blood tests to look for infectious triggers and for other conditions that can be confused with ADEM
Reviewed by Elias Sotirchos, MD November 2019

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