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Treatment of acute disseminated encephalomyelitis with intravenous immunoglobulin

From the McGill University Health Centre, the Montreal Neurological Hospital (Drs. Sahlas, Miller, and Francis), and the Montreal General Hospital (Drs. Guerin and Veilleux), Montreal, Québec, Canada.

Address correspondence and reprint requests to Dr. Demetrios J. Sahlas, Montreal Neurological Hospital, 3801 rue University, Montréal, Québec, Canada H3A 2B4; e-mail: mdjs{at}musica.mcgill.ca

Acute disseminated encephalomyelitis (ADEM) is a presumed immune-mediated, demyelinating disease of the CNS for which the standard treatment is high-dose steroids. We describe two patients with ADEM in whom treatment with IV methylprednisolone coincided with deterioration in their clinical status. They were subsequently treated with IV immunoglobulin and exhibited dramatic clinical improvement, with return to their previous level of functioning.

Key words: Acute disseminated encephalomyelitis—IV immunoglobulin—Methylprednisolone.

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