Please suggest a treatment for my child's ADEM.

Hi,

Welcome to icliniq.com, ADEM (acute disseminated encephalomyelitis) and Central nervous system inflammatory demyelinating disorders (CIDD) are usually treated with steroids, although the response to treatment is variable.

Hi,

Welcome back to icliniq.com. Acute disseminated encephalomyelitis (ADEM) is characterized by a brief, but widespread attacks of inflammation in the brain and spinal cord that damages myelin - the protective covering of nerve fibers. ADEM often follows viral or bacterial infections or less often, vaccination for measles, mumps or rubella. More thanhalf of the patients have an illness, usually an infection, two to four weeks before developing ADEM. Most of these illnesses are viral or bacterial, often no more than an upper respiratory tract infection. In children with ADEM, prolonged and severe headaches occur. In addition, the patient develops fevers during the ADEM course. Along with this pattern, the patients usually get neurological symptoms and that may include the following. 1. Confusion, drowsiness and even coma. 2. Unsteadiness and fall. 3. Visual blurring or double vision (occasionally). 4. Trouble with swallowing. 5. Weakness of the arms or legs. The first line of treatment of these patients is steroids. If there is no improvement on steroids, intravenous immunoglobulin should be administered. If both these fail, then plasmapheresis (filtering blood to remove the harmful substance) is the last option.

Hi,

Welcome back to icliniq.com. I have seen the magnetic resonance imaging (MRI) report (attachment removed to protect patient identity). We should start with high dose intravenous Methylprednisolone. If there is no response to treatment in 48 to 72 hours, switch over to intravenous immunoglobulin. If there is no response even with intravenous immunoglobulin (IV Ig), then go ahead with plasmapheresis.