Neurology: acute disseminated encephalomyelitis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Neurology: acute disseminated encephalomyelitis

Sample item

A 7-year-old develops fever, headache, drowsiness and multifocal neurological deficits two weeks after a viral illness. MRI shows multiple large, poorly marginated white matter lesions. Which diagnosis is most likely?

AHerpes simplex encephalitisBSubacute sclerosing panencephalitisCProgressive multifocal leukoencephalopathyDAcute disseminated encephalomyelitis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Acute disseminated encephalomyelitis

ADEM is a monophasic immune-mediated demyelination following infection or vaccination, with encephalopathy and multifocal deficits. It is treated with high-dose steroids. Herpes encephalitis focuses on the temporal lobes.

Option by option

A. Herpes simplex encephalitis
Herpes encephalitis involves the temporal lobes with haemorrhagic change and needs aciclovir.
B. Subacute sclerosing panencephalitis
SSPE is a slow progressive disease years after measles.
C. Progressive multifocal leukoencephalopathy
PML occurs in immunosuppressed adults with JC virus.
D. Acute disseminated encephalomyelitis (correct)
Correct. A post-infectious multifocal demyelinating illness with encephalopathy fits.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Acute disseminated encephalomyelitis. ADEM is a monophasic immune-mediated demyelination following infection or vaccination, with encephalopathy and multifocal deficits.

Why is "Herpes simplex encephalitis" not the answer?

Herpes encephalitis involves the temporal lobes with haemorrhagic change and needs aciclovir.

Why is "Subacute sclerosing panencephalitis" not the answer?

SSPE is a slow progressive disease years after measles.

Why is "Progressive multifocal leukoencephalopathy" not the answer?

PML occurs in immunosuppressed adults with JC virus.

What concept does this question test?

It tests Neurology: acute disseminated encephalomyelitis in General Medicine. It is treated with high-dose steroids. Herpes encephalitis focuses on the temporal lobes.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: acute disseminated encephalomyelitis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.