急性播散性脑脊髓炎(Acute disseminated encephalomyelitis,ADEM)与多发性硬化(multiple sclerosis,MS)都是中枢神经系统(CNS)脱髓鞘性疾病,但发病机制、治疗及预后不同。MS具有缓解复发的特点,ADEM病程多呈单向性,但也有部分复发;部分MS首次发作时与ADEM临床表现相似,因此临床首次发作时鉴别ADEM与MS一直是个难题。报道显示部分ADEM随访中转化为MS, Acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) are central nervous system (CNS) demyelinating diseases, but the pathogenesis, treatment and prognosis are different. MS has the characteristics of alleviating recurrence. The course of ADEM is mostly unidirectional, but it also has some recurrences. Some MS patients have similar clinical manifestations to ADEM when they first attack. Therefore, it is always a difficult problem to differentiate ADEM from MS in the first attack. Reported that some ADEM follow-up into MS,