A Case of Acute Disseminated Encephalomyelitis in an Adult Male with Bipolar Disorder

Acute disseminated encephalomyelitis (ADEM) is a rare demyelinating disease characterized by inflammation of the brain and spinal cord. The rapidly progressive inflammation in the central nervous system is known to occur in response to a prior infection or immunization. The clinical signs of ADEM may manifest up to 60 days post illness or vaccination. Some develop encephalopathy and neurologic symptoms which include confusion, psychosis, and tetraparesis. Paresthesia of the limbs and muscular atrophy indicate a worse prognosis and higher risk of relapse as opposed to those with only CNS involvement. A predominantly psychiatric presentation is also possible. Risk factors include male sex, winter, genetics, exposure to infectious organisms, immunization exposure, and lighter skin, and children less than age 10. The rapid course of ADEM warrants extra caution and need for early recognition in order to initiate prompt treatment