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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2025; 13(30): 112419
Published online Oct 26, 2025. doi: 10.12998/wjcc.v13.i30.112419
Published online Oct 26, 2025. doi: 10.12998/wjcc.v13.i30.112419
Silent triggers and symmetric peduncles - a rare presentation of adult-onset acute disseminated encephalomyelitis: A case report
Affan Faisal, Zain Tariq, Rania Usman Latif, Saim Amir, Abdul Basit, Department of Medicine, King Edward Medical University, Lahore 54000, Punjab, Pakistan
Abdul M Basil, Department of Medicine, Spinghar Medical University, Kabul 1001, Kābul, Afghanistan
Author contributions: Faisal A contributed to conceptualization; case management; manuscript writing – original draft; Latif RU contributed to literature review; manuscript editing; data interpretation; Tariq Z contributed to MRI analysis; image selection and figure preparation; critical review; Amir S contributed to clinical data curation; patient follow-up; writing – case presentation; Basit A contributed to Laboratory findings interpretation; serology review; manuscript review; Basil AM contributed to supervision; final manuscript approval; critical revision for intellectual content.
Informed consent statement: Written informed consent obtained for publication, including anonymized data and images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdul M Basil, MD, Department of Medicine, Spinghar Medical University, 4th Alley, Char Rahe Qambar Kabul, Kabul 1001, Kābul, Afghanistan.
Received: July 27, 2025
Revised: August 3, 2025
Accepted: August 22, 2025
Published online: October 26, 2025
Processing time: 76 Days and 19.4 Hours
Revised: August 3, 2025
Accepted: August 22, 2025
Published online: October 26, 2025
Processing time: 76 Days and 19.4 Hours
Core Tip
Core Tip: Acute disseminated encephalomyelitis (ADEM) is typically a pediatric, post-infectious demyelinating disease of the central nervous system. We report a rare case of idiopathic, adult-onset ADEM in a 55-year-old man with no preceding infection, vaccination, or autoimmune history. This case underscores the diagnostic complexity of ADEM in older adults, particularly when presenting with atypical symptoms and radiological findings. Early recognition and a high index of suspicion are critical for timely intervention, even in resource-limited settings. Our findings emphasize the need to broaden diagnostic considerations for encephalopathy and multifocal neurological deficits in adults.