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Case Report

Early Diagnosis and Treatment not Always a Key to Favorable Outcome: A Case Report of ADEM Correctly Diagnosed and Treated Still Surviving for Better Life

Vaibhav Gulati, PGY3, MEM {GWUUSA}, Dept. of Emergency Medicine, Max Super Specialty Hospital, Shalimar Bagh, New Delhi, Delhi 110088, India. , Aakansha Singh1 , Vaibhav Gulati1 , Kishalay Datta2 , Hilal Ahmad Yatoo3

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Indian Journal of Emergency Medicine 3(2):p 293-295, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.26

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Abstract

Acute disseminated encephalomyelitis (ADEM) is a rare disease of central nervous system with a spectrum of presentation. It is a diagnosis of exclusion and relies on neuroimaging which may be normal at the onset. It is a diagnostic challenge at its first attack. The disease is although more common in children it can invariably be present in adults. Here we present a case report of ADEM in a 30 year old female who presented to ER with history of multiple episodes of vomiting followed by sudden onset of dysphasia and other neurological complaints. The patient had a history of recent travel to a pilgrimage where she had enteric fever around 15 days ago. It was our neurology team which correctly recognised and treated it as ADEM. The patient responded well to the treatment and discharged in stable condition after 5days. Sadly the disease had a relapse which now showed no response to iv immunoglobulins, steroids or plasmapheresis. The patient was in the hospital for symptomatic management and is still surviving in the hope of a normal well being.

Keywords: Acute Disseminated Encephalomyelitis; Central Nervous System; Neuroimaging. 

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.26

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