Adult-Onset Acute Disseminated Encephalomyelitis Refractory to Steroids

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated phenomenon characterized by demyelination of the central nervous system that displays numerous manifestations. It predominantly presents in children with a mean age range of five to eight years. ADEM remains a diagnosis of exclusion based on clinical and radiographic progression. Thus, it poses a diagnostic challenge. ADEM has been shown to be very responsive to steroids and exchange therapy.Here, we present an unusual case of ADEM in a 50-year-old female patient who, despite receiving an entire course of IV methylprednisolone and other conventional treatment methods, did not respond to the treatment.