Acute Demyelinating Encephalomyelitis (“ADEM”) is generally a monophasic, inflammatory disease of the central nervous system that involves demyelination in both the brain and spinal cord.  While ADEM affects persons of all ages, children suffer ADEM more frequently than adults. 

The onset of ADEM can be quick and intense.  Symptoms can be general and range from mild (fever, fatigue,  headache) to severe as in seizures and coma.  Neurological symptoms are prominent and involve confusion, drowsiness, visual problems, numbness, tingling and weakness.   Complete recovery can occur, but patients with residual neurological effects are well described in the literature

ADEM often occurs following a viral or bacterial infection and has been reported after receipt of  vaccines.  While generally monophasic, recurrent ADEM is known to occur.  Acute Hemorrhagic Leukoencephalitis (“AHLE”) is a more severe form of ADEM that involves bleeding in the brain.  Some patients initially diagnosed with ADEM subsequently receive a diagnosis of Multiple Sclerosis.  The relationship of ADEM to multiple sclerosis remains ongoing. 

Althen v. Secretary of Health and Human Services is a bedrock case in the Vaccine program that sets forth the standard of proof necessary for an award of entitlement under the Vaccine Act and involved the onset of ADEM following tetanus toxoid (TT) vaccine.  

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