Fulminant Acute Disseminated Encephalomyelitis: A Remarkable Outcome with Cyclophosphamide

Hadas Meirson, Shelly I. Shiran, Michal Raz, Jonathan Roth, Aviva Fattal-Valevski*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system which occurs predominantly in the pediatric population. Acute treatment is high-dose intravenous glucocorticoids. Alternative treatment is usually intravenous immune globulin and/or plasma exchange. Fulminant ADEM is rare in children. Only a few cases of cyclophosphamide use in refractory ADEM have been reported. Here, we report a case of a 12-year-old girl with fulminant ADEM who was comatose and improved dramatically after cyclophosphamide administration. Cyclophosphamide treatment should be considered as a therapy in children with fulminant ADEM nonresponsive to standard therapies.

Original languageEnglish
Pages (from-to)270-275
Number of pages6
JournalJournal of Pediatric Neurology
Issue number4
StatePublished - 1 Aug 2021


  • acute disseminated encephalomyelitis
  • cyclophosphamide
  • intravenous immune globulin


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