Young Nathan P, Weinshenker Brian G, Lucchinetti Claudia F
Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Semin Neurol. 2008 Feb;28(1):84-94. doi: 10.1055/s-2007-1019130.
Acute disseminated encephalomyelitis (ADEM) is an uncommon monophasic idiopathic inflammatory demyelinating disease. Available diagnostic criteria do not reliably distinguish it from first presentations of relapsing diseases such as multiple sclerosis (MS) and neuromyelitis optica (NMO). In this article, we review current concepts about ADEM and what distinguishes it from other idiopathic inflammatory demyelinating disease, and we highlight controversial aspects and diagnostic problems. We review pathological differences between ADEM and MS in terms of their utility in the diagnosis of ADEM. Finally, we present a practical approach for management of patients suspected of having ADEM when the diagnosis is uncertain.
急性播散性脑脊髓炎（ADEM）是一种罕见的单相性特发性炎性脱髓鞘疾病。现有的诊断标准无法可靠地将其与复发型疾病如多发性硬化（MS）和视神经脊髓炎（NMO）的首次发病表现区分开来。在本文中，我们回顾了关于ADEM的当前概念以及它与其他特发性炎性脱髓鞘疾病的区别，我们强调了有争议的方面和诊断问题。我们从它们在ADEM诊断中的实用性角度回顾了ADEM和MS之间的病理差异。最后，我们提出了一种在诊断不确定时对疑似患有ADEM的患者进行管理的实用方法。
