Neurology: Case of the Month

Test Yourself — Patient 32

Acute Disseminated Encephalomyelitis (Presumptive)

  1. Which of the following statements regarding the prognosis of acute disseminated encephalomyelitis (ADEM) is correct?
    • [ A ] The prognosis is universally dismal with significant neurological compromise in all patients.
    • [ B ] The mortality rate exceeds 50% when enteroviruses are thought to be the inciting cause.
    • [ C ] Prognosis is variable, ranging from complete recovery in mild cases to death in severe cases.
    • [ D ] Prognosis is excellent with full recovery expected in most cases.
  2. Which of the following viruses have been associated with development of ADEM?
    • [ A ] Measles virus
    • [ B ] CMV
    • [ C ] EBV
    • [ D ] Corona virus
    • [ E ] A and C
    • [ F ] All of the above
  3. Concerning ADEM, which of the following statements is TRUE?
    • [ A ] ADEM is easily distinguishable from the first attack of multiple sclerosis based on MRI characteristics.
    • [ B ] The pathophysiology is well-known, and the disease clearly results from a T-cell mediated attack on myelin basic protein secondary to molecular mimicry.
    • [ C ] There is a unified consensus on treatment with IV steroids being the mainstay of all treatment.
    • [ D ] Disease presentation and progression are variable, depending largely on sites of CNS involvement.
  4. Treatment options include all of the following, EXCEPT:
    • [ A ] Immuran
    • [ B ] Cytoxan
    • [ C ] Solumedrol
    • [ D ] Plasma exchange
  5. Mutifocal neurological involvement may be seen in which of the following?
    • [ A ] ADEM
    • [ B ] CNS lymphoma
    • [ C ] Lyme disease
    • [ D ] Cystecercosis
    • [ E ] All of the above
    • [ F ] None of the above

 

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