What is the typical clinical course of Acute Disseminated Encephalomyelitis (ADEM) in children?

• A. Usually monophasic
• B. Typically chronic progressive
• C. Usually relapsing
• D. No neurological symptoms

Answer: (A)

In children, Acute Disseminated Encephalomyelitis usually follows a single acute attack after an infection or vaccination and presents with rapid onset of multifocal neurologic symptoms along with encephalopathy. The typical course is monophasic, meaning one episode with recovery over weeks to months and no ongoing or repeated attacks. This background explains why the best answer is that the condition is usually monophasic.

A chronic progressive course would imply ongoing deterioration, which is not how ADEM typically behaves. A relapsing course would imply multiple separate attacks, which is uncommon in classic pediatric ADEM (though a relapse can occur in rare cases or lead to considerations of other diagnoses like multiple sclerosis). Saying there are no neurological symptoms would be incorrect because ADEM, by definition, involves acute neurological deficits and encephalopathy during the attack.