HYBRID EVENT: You can participate in person at Orlando, USA or Virtually from your home or work.

6th Edition of International Conference on Neurology and Brain Disorders

October 24 -26, 2022

October 24 -26, 2022 | Orlando, Florida, USA
INBC 2022

Shely Azrad-Daniel

Speaker at Neurology and Brain Disorders 2022 - Shely Azrad-Daniel
Hospital Angeles Lomas, Mexico
Title : Acute disseminated encephalomyelitis in adults; a challenging diagnosis.


An acute disseminated encephalomyelitis (ADEM) is very challenging to diagnose. ADEM is rare, inflammatory and demyelinating disease that affects the central nervous system (CNS) with a typically white matter damage. ADEM often occurs following a viral or bacterial infection, or less often, vaccination for measles, mumps, or rubella. The symptoms of ADEM appear rapidly, with fever, fatigue, headache, nausea and vomiting, and in the most severe cases, seizures and coma. Its CNS affection leads to visual loss, paresis or even paralysis, and ataxia with bradykinesia. It can easily be misdiagnosed as an attack of multiple sclerosis (MS), since the symptoms and the appearance of the white matter injury on brain imaging may be similar. Here, we present a 22-year-old woman that presents to the emergency department because of urine retention of 24 hours and difficulty urinating for the past four days. We find paresis in both legs with difficulty climbing up stairs and standing up from a chair. We discover she had had an infectious gastroenteritis in the past two weeks. Her MRI showed ventral acute transverse myelitis from T4-T7 in the T2 sequence that did not highlight with gadolinium. We started IV steroids and performed a lumbar puncture which resulted negative for oligoclonal bands and infectious studies. The rtPCR stool test revealed norovirus so collecting the recent data, ADEM was diagnosed and we continued systemic steroid treatment until she was fully recovered and discharged. ADEM typically has a worse prognosis in adults as compared to children and can become fulminant with a mortality of 25% in adult patients. It has also been reported that ADEM associated with extensive transverse myelitis foretells a poor prognosis, but luckily, our patient evolved satisfactorily.

What will audience learn from your presentation?

• With this case presentation we can exemplify the truly wide clinical presentation of ADEM and the importance of prompt IV treatment.
• In this case, the patient was out of the age-related descriptions because she was already an adult and this disease usually appears in children. This will help open our eyes to consider ADEM in the future.
• This information will help us, neuroscientists, identify these not-so prevalent diagnoses in neurology like ADEM that can mimic other pathologies as multiple sclerosis and make us doubt about the proper management.


Dr. Shely Azrad-Daniel studied her medical degree in Anahuac University, in Mexico City, graduating with honors in 2017. She started doing research in neurology, cardiology and pneumology at the National Cardiology Institute “Ignacio Chavez” and the National Institute for Respiratory Diseases (INER) “Ismael Cosío Villegas”. She then obtained a master’s degree in Clinical Nutrition in 2019 by Anahuac University. In 2019 she started her four-year residency in Internal Medicine at Angeles Lomas Hospital, Mexico City, where she does clinical research until today. She plans to go into neurology fellowship and become a Neurology Professor at her home university.