|The Disease (ADEM)
"Acute disseminating encephalomyelitis (ADEM) is an acute or subacute illness that typically follows a viral infection or immunization. Pathologically, the lesions of ADEM are areas of demyelination. Demyelination refers to the destruction of some or all of the myelin sheath. Myelin insulates the nerve axon. In ADEM, normally it is destroyed by the body's immune system because the system is no longer capable of recognizing the myelin as belonging to the self, rather as a foreign invader that must be destroyed.
"The typical clinical presentation of ADEM is multifocal neurologic abnormalities reflecting a widespread central nervous system disturbance.
"Neurologic symptoms in ADEM characteristically begin one to three weeks after an infection or immunization. The illness has been described following rubeola, vaccinia, varicella, mycoplasma, mumps, rubella, and nonspecific respiratory infections, but may occur without a recognizable preceding event...Confusion and lethargy are frequent and may progress to coma..."
---Adapted from "MRI in acute disseminated encephalomyelitis" by K.S. Caldemeyer, R.R. Smith, T.M. Harris, M.K. Edwards.
Neuro-radiology Springer-Verlag, 1994