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Questions with answers:
1. Is ADEM more common in in children or adults?
ADEM is more common in children.

2. ADEM has similar clinical symptoms and MRI changes as multiple sclerosis.
What may the clinical symptoms and MRI changes of ADEM mimic?

3. How many symptomatic episodes of ADEM is a patient likely to experience?
Typically there is only one episode of ADEM, unlike multiple sclerosis, which is a relapsing-remitting disorder.

4. Is optic neuritis seen in some patients with ADEM?Yes, unilateral or bilateral optic neuritis often with optic disc edema is seen in some patients with ADEM.

Explanation:
“8.4.7 Acute Disseminated Encephalomyelitis
Acute Disseminated Encephalomyelitis (ADEM) or subacute encephalomyelitis occurs during the course of various infections, most often as a post infectious or autoimmune response. It is particularly common in children, but it may occur at any age.

The clinical symptoms and MRI changes may mimic multiple sclerosis; however, unlike multiple sclerosis, which is a relapsing-remitting disorder, patients usually have only one episode of ADEM. Unilateral or bilateral optic neuritis (often with disc edema)may develop during the course of ADEM.”²

References:
1. MRI in acute disseminated encephalomyelitis following Semple antirabies vaccine. Murthy JM. Neuroradiology. 1998;40(7):420-3.
2. Neuro-ophthalmology Illustrated-2nd Edition. Biousse V and Newman NJ. 2012. Theme

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