What is the Difference Between ADEM and MS

Acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) are two different inflammatory autoimmune disorders. In both ADEM and MS, the target of the attack is myelin, which is the protective insulation that covers nerves throughout the central nervous system (CNS).

The key difference between ADEM and MS is the number of attacks on myelin. ADEM involves a single attack on the myelin of the nerves, while MS involves multiple attacks on the myelin of the nerves.

CONTENTS

1. Overview and Key Difference
2. What is ADEM 
3. What is MS
4. Similarities – ADEM and MS
5. ADEM vs MS in Tabular Form
6. Summary – ADEM vs MS
7. FAQ – ADEM and MS

What is ADEM?

ADEM (acute disseminated encephalomyelitis) is an acute inflammatory autoimmune condition that involves severe inflammation affecting the brain and spinal cord. The symptoms of this condition are confusion, fever, nausea, vomiting, headache, and seizure. The episode of ADEM is typically a singular occurrence, and the majority of individuals recover fully within six months from this condition. Complications may include memory loss, cognitive processing delays, coma, severe headaches, numbness, coordination difficulties, and blurry vision.

ADEM can be diagnosed through physical examination, neurological testing, MRI, and spinal fluid testing. Additionally, treatment options may include steroid medications, intravenous immunoglobulin (IVIG), and plasma exchange.

What is MS?

Multiple sclerosis (MS) is a long-lasting disease of the central nervous system that affects both the brain and spinal cord. Progressive forms of MS cause steady deterioration and permanent disability. The symptoms of MS are blurred vision, red-green discoloration, pain and loss of vision because of optic neuritis, trouble walking, paraesthesia, muscle weakness in the arms and legs, trouble with coordination, spasticity, fatigue, loss of sensation, speech problems, tremor, dizziness, hearing loss, bowel and bladder problems, depression, and changes in sexual functions. Moreover, MS can be caused by autoimmune disorders, infectious agents like viruses, environmental factors, and genetic factors. The complication involved in this condition is impaired mobility (paralysis).

MS can be diagnosed through physical examinations, neurological examinations, and MRI. Furthermore, treatment options for MS are medications (anti-seizure medications, donepezil), physical therapy, and occupational therapy.

Similarities Between ADEM and MS

• Acute disseminated encephalomyelitis and multiple sclerosis are two different inflammatory autoimmune disorders.
• Both are due to the immune system attacking the myelin sheath.
• Both can be diagnosed through physical evaluation and neurological examination.
• They can be treated through specific medications and therapies.

Difference Between ADEM and MS

Definition

1. ADEM is an inflammatory autoimmune condition that involves a single attack on the myelin of the nerves.
2. MS is an inflammatory autoimmune condition that involves multiple attacks on the myelin of the nerves.

Causes

1. ADEM is associated with autoimmune responses and infections.
2. MS is associated with autoimmune disorders, infectious agents like viruses, environmental factors, and genetic factors.

Symptoms

1. ADEM symptoms may include confusion, fever, nausea, vomiting, headache, and seizures.
2. MS symptoms may include blurred vision, red-green discoloration, optic neuritis-related pain and vision loss, difficulty walking, paraesthesia, muscle weakness, coordination problems, spasticity, fatigue, sensory loss, speech difficulties, tremors, dizziness, hearing loss, bowel and bladder issues, depression, and changes in sexual function.

Complications

1. ADEM complications may involve memory loss, cognitive processing delays, coma, severe headaches, numbness, coordination difficulties, and blurry vision.
2. MS complications may include impaired mobility (paralysis).

Diagnosis

1. ADEM diagnosis involves physical examination, neurological testing, MRI, and spinal fluid testing.
2. MS diagnosis involves physical examination, neurological examination, and MRI.

Treatment

1. Treatment for ADEM may include steroid medications, intravenous immunoglobulin (IVIG), and plasma exchange.
2. Treatment for MS may involve medications (such as antiseizure medications and donepezil), physical therapy, and occupational therapy.

The infographic below presents the differences between ADEM and MS in tabular form for side-by-side comparison.

Summary – ADEM vs MS

ADEM and MS are two different inflammatory autoimmune disorders. Both are due to the immune system attacking the myelin sheath, which protects central nervous system. However, ADEM involves a single attack on the myelin of the nerves while MS involves multiple attacks on the myelin of the nerves. Furthermore, People with ADEM make a full recovery within six months whereas MS is a lifelong condition. Thus, this summarizes the difference between ADEM and MS.

FAQ: ADEM and MS

1. What is the cause of ADEM?

• The exact cause is not known. But in most of the cases, symptoms appear following a viral or bacterial infection, and very rarely following vaccination. Therefore, most often, ADEM begins about 4 to 14 days after an infection.

2. What is the survival rate of ADEM?

• The prognosis for most individuals with ADEM is very good. The recovery process may take place over four to six weeks or full recovery before 6 months. Moreover, 60 to 90 % of the population have no neurological deficits.

3. Can ADEM be cured?

• Most people achieve complete recovery from ADEM. The main medication for treating ADEM is a type of steroid. Most children tolerate this medication very well. In approximately 80 percent of children, ADEM occurs only once as a single episode.

4. What are the common complications of multiple sclerosis?

• The common complications of multiple sclerosis are muscle problems, including loss of balance, muscle spasms, numbness, trouble moving your arms or legs, and trouble walking.

5. What is the most serious form of MS?

• Multiple Sclerosis is a disease of the central nervous system, which is made up of the brain, spinal cord, and optic nerve. Fulminant multiple sclerosis is the most malignant form of MS and is also known as Marburg-type MS.

Reference:

1. Anilkumar, Arayamparambil C. “Acute Disseminated Encephalomyelitis.” StatPearls [Internet]., U.S. National Library of Medicine.
2. “Multiple Sclerosis (MS).” Johns Hopkins Medicine.

Image Courtesy:

1. “Fulminating ADEM showing many lesions” By Rodríguez-Porcel F, Hornik A, Rosenblum J, Borys E, Biller J – National Library of Medicine (CC BY 4.0) via Commons Wikimedia

2. “Symptoms of multiple sclerosis” By Mikael Häggström -(Public Domain) via Commons Wikimedia