ACUTE C

ENTRAL N

ERVOUS

SYSTE

M DEMYE

LINAT

ION

5 D

I AG

NO

SE

S T

O K

NO

W

ACUTE DISSEMINATED ENCEPHALOMYELITISAcute or Subacute

Multifocal Neurologic Deficits with Encephalopathy

Post Viral or Vaccination

Fever, headache, neck pain, ataxia

High Dose Steroids

IVIg

MULTIPLE SCLEROSIS

Chronic

Recurrent episodes demyelination over space and time

Oligoclonal bands may be present in CSF

Interferon B

Immunomodulatory, cytotoxic therapies

OPTIC NEURITIS

First episode of inflammatory demyelinating event

Isolated or in context of ADEM, MS, NMO

Optic disk swollen in 75%

MRI brain and orbits with gadolinium

High dose steroids

TRANSVERSE MYELITIS

Spinal cord

Rapid onset over hrs or days

Weakness, paresthesias, sphincter dysfunction, urinary retention

Isolated or in context of ADEM, MS, NMO

Overlap with Guillain Barre, MRI distinguishes

Encephalopathy uncommon but may occur w/brainstem involvement

High Dose Steroids

IVIg

Plasmapheresis

OTHER CONSIDERATIONS

SLE

Sarcoid

Malignancy

Mitochondrial Disease

Leukodystrophy