encefalomielite

Encefalomielite is a medical term that refers to inflammation of both the brain and the spinal cord. It is not a single disease but a syndrome that can result from various causes, including infections, autoimmune reactions, and demyelinating disorders. ADEM (acute disseminated encephalomyelitis) is a common form in children and is often triggered by a recent viral illness or vaccination. Other etiologies include viral encephalitis with concurrent myelitis, autoimmune encephalomyelitis, and flare-ups of conditions such as multiple sclerosis or neuromyelitis optica spectrum disorders.

Clinical presentation is diverse and may include fever, headache, confusion or decreased consciousness, seizures, as well as focal neurological deficits such as weakness, sensory changes, ataxia, or cranial nerve palsies. The disease typically evolves over days and may require urgent evaluation for infectious and other inflammatory etiologies.

Diagnosis relies on imaging and laboratory studies. MRI of the brain and spinal cord commonly shows multifocal demyelinating or inflammatory lesions. Cerebrospinal fluid analysis can show elevated white blood cells and protein; oligoclonal bands may be present. Additional tests are used to exclude infections and to identify autoimmune markers.

Current treatment focuses on controlling inflammation and supporting recovery. First-line therapy often involves high-dose corticosteroids; intravenous immunoglobulin (IVIG) or plasmapheresis may be offered in severe or refractory cases. Treatment of underlying infections and supportive care are important. The prognosis varies; many patients recover partially or fully, while others may have lasting neurological deficits or experience relapses, depending on the cause and promptness of treatment.