Acute disseminated encephalomyelitis (ADEM) is a presumed immune-mediated,
demyelinating disease of the CNS for which the standard treatment is high-d
ose steroids. We describe two patients with ADEM in whom treatment with IV
methylprednisolone coincided with deterioration in their clinical status. T
hey were subsequently treated with IV immunoglobulin and exhibited dramatic
clinical improvement, with return to their previous level of functioning.