IJCNMH ARCpublishing

Issue: Issue 3 (2016) – Supplement 3

Case Report

Multiphasic ADEM reclassified in Multiple Sclerosis: a case with therapeutic implications

Luís Braz, Mafalda Sampaio, Joana Guimarães, and Miguel Leão
Introduction: Acute disseminated encephalomyelitis (ADEM) is classically defined as a multifocal encephalopathic and typically monophasic demyelinating inflammatory clinical event. A multiphasic form of ADEM has been recognized; differentiating multiphasic ADEM from Multiple Sclerosis (MS) may represent a diagnosis challenge. 
Case Report: We present the case of a patient with a five episodes of subacute encephalopathy together with various focal neurological deficits, suggestive of multiphasic ADEM. Lastly, a sixth event presented as a non-encephalopathic relapse. According to the new criteria for diagnosis of pediatric acquired demyelinating syndromes, the patient actually displays a chronic relapsing disease like. However, 5 years after onset of illness, the patient is being treated with Azathioprine 150 mg/day and remains clinical and imagiologically stable. 
Discussion: Progression to MS occurs in pediatric patients in which the initial presentation is ADEM; however, in this patient, the current stability raises questions about the need for changing the current therapeutic regimen.

Keywords: Acute disseminated encephalomyelitis, Multiphasic Acute disseminated encephalomyelitis, Multiple Sclerosis.

Special Issue on Inflammatory Demyelinating Diseases of the Central Nervous System

International Journal of Clinical Neurosciences and Mental Health 2016; 3(Suppl. 3):S08
DOI: http://dx.doi.org/10.21035/ijcnmh.2016.3(Suppl.3).S08
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