Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory immune-mediated demyelinating disorder of the central nervous system usually occurring after a post infectious or post vaccineal event.(1) It is usually monophasic but can be polyphasic or be recurrent making the diagnosis difficult(2). Commonly affects the children. There is activation of t cell clones causing widespread demyelination involving the white matter of the brain and spinal cord. As it can affect any part of the neuraxis the clinical features are variable and polysymptomatic.