Adem, diagnostic dilemma, a tertiary care hospital experience.

Rajesh Kumar, Liaquat National Hospital,Karachi.
hazim brohi, Aga Khan University


Acute disseminated encephalomyelitis (ADEM) is an uncommon inflammatory demyelinating disease of the central nervous system that usually occurs following a viral infection or vaccination, bacterial or parasitic infection, or even spontaneously. ADEM is a monophasic; poly symptomatic disorder but it may present with various combinations of motor, sensory, visual and cognitive symptoms. Some case reports of ADEM presented as psychiatric disorders primarily as confusion psychosis and at times dissociative disorder. At times, the diagnosis becomes a dilemma due to multifaceted picture. Due to confusion physician may go to extreme range of tests with no specific conclusion. Debates regarding exact diagnosis have always been there. Reports regarding ADEM are lacking from our country. The aim of our study is to look for the presenting features of the disease and the path to final diagnosis.