ADEM treatment in India: Acute disseminated encephalomyelitis (ADEM) is the abrupt development of multiple neurological signs related to an inflammatory, demyelinating disorder of the brain and spinal cord. ADEM follows childhood viral infections such as measles and chickenpox or vaccinations and resembles multiple sclerosis clinically.

Symptoms of ADEM

Two weeks prior to the onset of disease, the majority of people experience ADEM symptoms. The major condition is basically a viral or bacterial infection – upper respiratory tract infection. It can be another type of infection.

Symptoms usually come on suddenly and can include:

People with ADEM experience a sudden bout of symptoms including:

Drowsiness

Balance problems

Numbness, tingling in hands and legs

Weakness or fatigue

Stiff neck

Confusion

Headache

Fever

Bowel or Bladder issues

Vision problems

Blurred or double vision

Optic neurosis (optic nerve inflammation)

Swallowing difficulty and speaking problems

At times ADEM can also lead to seizures or coma.

In the majority of the cases, symptoms can last for a few days and get better with treatment. However, sometimes, symptoms can become worse and persist for several months.

Treatment of ADEM in India

ADEM is associated with inflammation of the central nervous system. Therefore, the main goal of the treatment is to minimize inflammation in the central nervous system.

Steroid medication is the preferred mode of treatment for ADEM. Steroid is administered for up to six to seven days. Solu-Medrol (methylprednisolone) is the steroid medication. Some oral steroids like Deltasone (prednisone) may also be recommended for a brief time – which could be given based on the prescription of the doctor – may be for around a few days to weeks.

Side-effects are common with steroid treatment. Careful monitoring is done to see whether the adverse effects are under control. Flushing, facial swelling and metallic taste in the mouth are common side effects. Difficulty falling to sleep and weight gain are other potential side effects.

In case of failure of steroidal treatment, another modality of treatment involves intravenous immune globulin (IVIG). This medicine is given intravenously for around four to six days. Some of the adverse effects of this medicine include shortness of breath, allergic reaction and infections.

If the problem is not controlled with the above treatment or when the above treatment doesn’t respond, then plasmapheresis is considered. The procedure involves the separation of harmful antibodies from the blood. This technique is repeated several times.

If the patient doesn’t respond well to all of the above treatments then chemotherapy is considered. Apart from this ADEM treatment in India, doctors are actively working on other modalities as well.