ACUTE DISSEMINATED ENCEPHALOMYELITIS IN A PEDIATRIC PATIENT: A CASE STUDY

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2013-04-12

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Long, Alia

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Abstract

Purpose: The purpose of this study is to present a unique case of a pediatric patient with acute disseminated encephalomyelitis (ADEM) who was treated with corticosteroids. Methods: The pathogenesis of ADEM is primarily unknown. The significance of this case study is to present the clinical findings, neurologic changes during the patient's hospital stay, and describe radiological imaging that ultimately led to the diagnosis of ADEM. Results: A case of ADEM in a patient with a past medical history of mental retardation, ADHD, and Bipolar disease was presented. The combination of high-dose methylprednisolone, occupational therapy, and physical therapy resulted in improvement of the patient's level of pain, neurologic findings, and range of motion in her upper and lower extremities. The treatment modalities, possible long-term adverse sequelae as a result of ADEM, review of literature, and discussion and management of ADEM were reviewed. Conclusions: ADEM is an uncommon phenomenon that can be frustrating for patients and physicians as a result of the difficulty in establishing the diagnosis, unknown etiology, and wide variability in morbidity and neurologic deficits that can result. While evidence has shown that ADEM can be the result of a pathological process or may be associated with vaccinations, high-dose steroids combined with physical therapy and occupational therapy may be an effective treatment modality.

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