3195 A case report of acute disseminated encephalomyelitis with prominent meningeal involvement and benefit from delayed plasma exchange therapy

the age.Although the disease typically affects patients of middle-age (median age of onset is 39 years) it is important to remember that 15-20% of patients may present to paediatricians (<16 years) or elderly care physicians (>65 years).It should be suspected when the MRI spine demonstrates a longitudinally extensive spinal cord lesion, extending for three or more vertebral segments, primarily involving the central cord gray matter.The syndrome is rare therefore there are no randomised controlled trials to guide treatment.Relapses are severely disabling, therefore prevention with immunosuppression is the most important aspect of management.