This condition affects 1 in every 125,000 to 250,000 individuals in a given year
A 2.5 year old boy suffering from a rare brain inflammatory condition called Acute Disseminated Encephalomyelitis (ADEM) was treated successfully at Fortis hospital, Bannerghatta Road. The team of doctors was led by Dr Yogesh Kumar Gupta, Consultant-Pediatrician and Intensivist, Head of PICU, Fortis Hospitals, Bannerghatta road and Dr Ashok Kumar Singhal, Consultant- Neurology, Fortis Hospitals, Bannerghatta Road.
Parents brought the child to Fortis Hospital with a complaint of fever that lasted more than a week. He had difficulty in swallowing (could not even swallow his own saliva, Aphasia (Loss of acquired ability to speak) along with prolonged episodes of fits. At the time of admission to PICU he was in altered state of consciousness. Post MRI scanning and Cerebro-spinal fluid testing, doctors identified it as Acute Disseminated Encephalomyelitis (ADEM). It is described as a life-threatening illness that targets the central nervous system and spinal cord cells. In this immune-mediated disorder, there is a widespread inflammation of the brain and spinal cord, further damaging the nerve tissue.
Dr Yogesh Kumar Gupta, Consultant-Pediatrician and Intensivist, Head of PICU at Fortis Hospitals, Bannerghatta road, said “Being a rare disease, we made it a point to conduct MRI scanning and spinal fluid test to confirm that it was a case of ADEM after ruling out other diseases that can present like ADEM. The child had lost the ability to think and react, as, in this condition the protective covering of nerve fibers (Myelin) that make up part of the central nervous system responsible for carrying messages between the brain and the body get damaged. After confirming the diagnosis, we started the child on IV Corticosteroids which is considered as the preferred treatment after a discussion with Neurologist. Corticosteroids help in ADEM by reducing the inflammation and controlling the immune reaction. The child was kept under observation and gradually on the third day of the medication, the child started showing recovery signs. He became alert, started interacting with parents and started consuming small quantities of water and by day five, he was alert, smiling and was able to swallow the food normally. Only deficit remaining was the ability to speak. After completing the injections, he was put on oral steroids. By day 8 child started speaking and became completely normal as before. What makes this case interesting is his complete recovery as majority of the cases of ADEM would end up in some or other neurological deficit.”
Parents of the child, said, “We were extremely worried and had lost all hopes as my child’s condition was deteriorating day by day. None of the hospitals were able to diagnose my child’s condition, we were relieved when we came to Fortis. Through continuous monitoring and care by the doctors and the hospital staff my child recovered. His recovery progression went from zero to 100 in a matter of 8 days. We are grateful to the team of doctors who guided and treated my child well.”
According to National Multiple Sclerosis Society, “ADEM can appear at any age, however children are more likely than adults to develop it. More than 80 percent of childhood cases occur in patients younger than 10 years. Most of the remaining cases occur between the ages of 10 and 20 but ADEM is sometimes (rarely) diagnosed in adults. ADEM is thought to affect 1 in every 125,000 to 250,000 individuals in a given year.”