Acute Disseminated Encephalomyelitis – Board-Style Questions

What this deck covers

acute disseminated encephalomyelitis in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. More than the limbs
2. Reading the scan
3. What the tap showed
4. Looking back a month
5. Who gets it
6. A second episode
7. Which way will it go
8. Far too fast
9. The eyes as well
10. Starting treatment
11. Not responding
12. Stopping the tablets
13. The brain trace
14. The scan afterwards
15. Tired and irritable
16. The booster question
17. Stiff neck and fever
18. Will it come back

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A positive antibody test in the blood or spinal fluid, Large ill-defined bilateral lesions, often involving deep grey matter, Persistent oligoclonal bands present only in the spinal fluid sample, A family history of the same illness in a parent, A young child under ten, most often in winter or spring, A relapse of the first event, since it is the same illness, A preceding viral illness three weeks before the presentation, Posterior reversible encephalopathy after a hypertensive crisis, Inflammation of both optic nerves, which is common in children, Oral prednisolone alone for five days with no taper, Oral azathioprine started now for long-term control, Change to inhaled steroid for the next three months, Generalised slow activity, in keeping with an encephalopathy, No further imaging, as he has made a full recovery.

Clinical pearls from this deck

• No encephalopathy, no ADEM: the label needs both.
• ADEM on MRI: big, fuzzy, both sides, deep grey too.
• ADEM fluid: a few lymphocytes, and no lasting bands.
• ADEM usually follows a virus two to four weeks before.
• ADEM: a young child, in the cold half of the year.
• Beyond three months with encephalopathy: multiphasic ADEM.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Neurology case decks · pediatric reference values.