Comparative features of ADEM and multiple sclerosis (MS)
| More likely in ADEM | More likely in MS | |
|---|---|---|
| CSF, cerebrospinal fluid; MRI, magnetic resonance imaging. | ||
| ▸ Age | Children | Adults |
| ▸ Sex | Slight male preponderance in children reversed in adults | Approximately twice as common in women |
| ▸ Symptoms | Antecedent infection | Usually less severe |
| Antecedent immunisation | Unilateral optic neuritis | |
| Usually more severe | Slowly progressive symptoms | |
| Fever | ||
| Headache | ||
| Meningism | ||
| Coma | ||
| Brainstem symptoms | ||
| Seizures | ||
| Multifocal neurological deficit | ||
| Bilateral optic neuritis | ||
| ▸ CSF | Pleocytosis | Oligoclonal bands |
| Raised albumin fraction | ||
| Raised protein | ||
| ▸ MRI | Larger lesions | Periventricular lesions |
| Mass effect and oedema | Heterogeneous gadolinium enhancement | |
| Grey matter involvement | T1 hypointensities (“black holes”) | |
| Uniform gadolinium enhancement | New lesions on follow up scan | |
| Normal or resolving follow up scan (no new lesions) | ||