Systemic paediatrics: acute disseminated encephalomyelitis: practice question

A Pediatrics 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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Pediatrics · Systemic paediatrics: acute disseminated encephalomyelitis

Sample item

A 6-year-old develops fever, encephalopathy, ataxia and visual loss two weeks after a viral illness. MRI shows multiple large, poorly marginated T2 hyperintense lesions in the subcortical white matter and basal ganglia. What is the first-line treatment?

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

The answer and the reasoning

C. High-dose intravenous methylprednisolone

Acute disseminated encephalomyelitis is a monophasic, post-infectious or post-vaccination immune demyelination with encephalopathy and multifocal MRI lesions. High-dose IV methylprednisolone is first-line, with IVIG or plasma exchange for failures. Most children recover well, and multiple sclerosis is suspected only if relapses occur.

Option by option

  • A. Intravenous acyclovir alone

    Acyclovir alone treats herpes encephalitis, which does not give this multifocal pattern after infection.

  • B. Antitubercular therapy

    Antitubercular therapy treats tuberculoma or tuberculous meningitis, which have basal exudates and hydrocephalus.

  • C. High-dose intravenous methylprednisolone (correct)

    Correct. High-dose steroids suppress the immune-mediated demyelination.

  • D. Interferon beta

    Interferon beta is a long-term disease-modifying agent for multiple sclerosis.

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.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, High-dose intravenous methylprednisolone. Acute disseminated encephalomyelitis is a monophasic, post-infectious or post-vaccination immune demyelination with encephalopathy and multifocal MRI lesions.

Why is "Intravenous acyclovir alone" not the answer?

Acyclovir alone treats herpes encephalitis, which does not give this multifocal pattern after infection.

Why is "Antitubercular therapy" not the answer?

Antitubercular therapy treats tuberculoma or tuberculous meningitis, which have basal exudates and hydrocephalus.

Why is "Interferon beta" not the answer?

Interferon beta is a long-term disease-modifying agent for multiple sclerosis.

What concept does this question test?

It tests Systemic paediatrics: acute disseminated encephalomyelitis in Pediatrics. High-dose IV methylprednisolone is first-line, with IVIG or plasma exchange for failures. Most children recover well, and multiple sclerosis is suspected only if relapses occur.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Systemic paediatrics: acute disseminated encephalomyelitis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.