{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:16:35Z","timestamp":1753877795264,"version":"3.41.2"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,17]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute disseminated encephalomyelitis (ADEM) is a monophasic demyelinating disorder of central nervous system occurring in children with a wide range of clinical manifestations after infection or vaccination. There are few case reports in literature, describing atypical presentations of ADEM with fever of unknown origin, autonomic dysfunction, complex movement disorders such as myoclonus, dystonia and chorea, acute psychosis and myocarditis. Here, we report four cases of ADEM with atypical features like uniocular blindness, myelin oligodendrocyte glycoprotein antibodies negative multiphasic disseminated encephalomyelitis, ADEM mimicking Guillain-Barre syndrome at presentation and isolated spinal ADEM. Treatment with high-dose steroids elicited an excellent neurological outcome in all patients. A high index of clinical suspicion along-with awareness of atypical features, magnetic resonance imaging and cerebrospinal fluid studies are of paramount importance in establishing ADEM diagnosis and initiation of early treatment for better outcome.<\/jats:p>","DOI":"10.1093\/tropej\/fmab045","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T20:42:12Z","timestamp":1620420132000},"source":"Crossref","is-referenced-by-count":1,"title":["Rare and Atypical Presentations of Acute Disseminated Encephalomyelitis in Children: A Case Series"],"prefix":"10.1093","volume":"67","author":[{"given":"Sunil Kumar","family":"Hemram","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Midnapore Medical College, West Bengal 721101, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arindam","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Midnapore Medical College, West Bengal 721101, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba","family":"Annigeri","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Midnapore Medical College, West Bengal 721101, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,6,7]]},"reference":[{"key":"2021070811475629300_fmab045-B1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.msard.2017.09.018","article-title":"Short term outcome of ADEM: results from a retrospective cohort study from South India","volume":"18","author":"Iype","year":"2017","journal-title":"Mult Scler Relat Disord"},{"key":"2021070811475629300_fmab045-B2","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1186\/1471-2431-11-103","article-title":"Acute disseminated encephalomyelitis presenting as fever of unknown origin: case report","volume":"11","author":"Di Costanzo","year":"2011","journal-title":"BMC Pediatr"},{"key":"2021070811475629300_fmab045-B3","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1542\/peds.142.1MA5.471","article-title":"Atypical ADEM and cardiogenic shock in a 14-years-old-female: case report","volume":"142","author":"Werner","year":"2018","journal-title":"Pediatrics"},{"key":"2021070811475629300_fmab045-B4","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/1352458518786074","article-title":"Paediatric MOG antibody-associated ADEM with complex movement disorder: a case report","volume":"25","author":"Sa","year":"2019","journal-title":"Mult Scler"},{"key":"2021070811475629300_fmab045-B5","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1111\/j.1600-0420.2006.00773.x","article-title":"Isolated bilateral optic neuritis in acute disseminated encephalomyelitis","volume":"84","author":"Bansgaard","year":"2006","journal-title":"Acta Ophthalmol Scand"},{"key":"2021070811475629300_fmab045-B6","doi-asserted-by":"crossref","first-page":"242","DOI":"10.4103\/ijo.IJO_939_16","article-title":"Clinical profile and neuroimaging in pediatric optic neuritis in Indian population: a case series","volume":"65","author":"Khadse","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"2021070811475629300_fmab045-B7","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.msard.2019.07.012","article-title":"A unique case of multiphasic ADEM or what else?","volume":"35","author":"Losavio","year":"2019","journal-title":"Mult Scler Relat Disord"},{"key":"2021070811475629300_fmab045-B8","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.msard.2018.09.007","article-title":"Recurrent disseminated encephalomyelitis: a case report and literature review","volume":"26","author":"Shah","year":"2018","journal-title":"Mult. 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