Prognosis & Management
The prognosis for most individuals with ADEM is good. The recovery process may take place over four to six weeks, but the majority of those with ADEM make a fairly significant recovery. Between 60 to 90 percent are left with no neurological deficits. Those who do have residual symptoms can have residual weakness or sensory disturbances, bowel/bladder dysfunction, recurrent headaches, and behavioral and neurocognitive problems. Interestingly, the location of lesions and the extent of inflammatory lesions do not appear to have any predictive value in regard to outcome. Typically, follow-up MRIs show complete or partial resolution of abnormalities in the majority of ADEM cases. Those who are positive for MOG antibodies are unlikely to be later diagnosed with Multiple Sclerosis or NMOSD, but may have relapses of ADEM, Optic Neuritis, and Transverse Myelitis.