Traditional Chinese Medicine believes that acute disseminated encephalomyelitis falls under the categories of "spring warmth," "summerheat warmth," "pestilence," and "atrophy-flaccidity disease." The pathological causes of the disease are briefly described as follows:

Insufficient healthy qi in the body, weakened defensive function, invasion of the body by warm epidemic toxins, depletion of true yin, yin deficiency with effulgent fire, scorching damage to body fluids, loss of nourishment to the eyes; heat toxin combined with dampness, dampness-heat toxin spreading, limb paralysis, and even phlegm-heat epidemic toxin reversing transmission to the pericardium, leading to a deteriorated pattern.

bubble_chart Modern Research

Acute disseminated encephalomyelitis is an acute demyelinating disease that extensively affects the brain and spinal cord, especially the white matter of the spinal cord. Clinically, it often presents with acute onset, primarily manifesting as psychiatric symptoms and neurological symptoms, along with signs of meningeal irritation. Involvement of the optic nerve may lead to visual impairment or loss; lesions in the cerebral hemispheres or brainstem may result in hemiplegia or quadriplegia, respectively. Based on clinical manifestations, acute disseminated encephalomyelitis can be classified into cerebral type, spinal type, and cerebrospinal type. This disease is more common in young adult males and can occur in any season.

Acute disseminated encephalomyelitis is commonly seen:

1. After certain viral or bacterial infections, also known as post-infectious encephalomyelitis;
2. After vaccination, also known as post-vaccination encephalomyelitis;
3. With no obvious precipitating factors, it may be referred to as idiopathic acute disseminated encephalomyelitis.

[Diagnosis]

The diagnosis of acute disseminated encephalomyelitis must be determined by comprehensive analysis of infection history or vaccination history, symptoms, signs, and laboratory tests.

1. Epidemiological data often show a viral infection 1-2 weeks before onset, such as measles, rubella, chickenpox, mumps, or common cold.
2. A history of vaccination before onset is commonly seen with rabies vaccination, followed by smallpox vaccine.
3. Symptoms often present acutely, with sudden headache, vomiting, confusion, and signs of meningeal irritation; or hallucinations, delusions; loss of vision, even unconsciousness and decerebrate rigidity; or sudden paralysis.
4. Signs include increased intracranial pressure, meningeal irritation signs, and papilledema. In the spinal type, there are manifestations of transverse spinal cord damage below the lesion level, complete motor paralysis, loss of deep and superficial sensations, and bladder paralysis. During the shock phase, muscle tone is low, tendon reflexes are low or absent, and pathological signs are negative; during the convalescence stage, muscle tone is high, tendon reflexes are hyperactive, and pathological signs are positive.
5. Laboratory and other tests often show grade II mononuclear cell increase in cerebrospinal fluid, occasionally exceeding 10×10^7/L. Protein may increase to 1.0 g/L, mostly globulin and IgG. EEG shows an increase in slow waves, often high-amplitude 4-6 Hz Q waves.

bubble_chart Pattern Analysis

1. Pathogen Invading Defense and Qi (Encephalopathic ︰Fever, aversion to cold (or no aversion to cold), headache, somnolence, thirst, dysphoria, neck stiffness, convulsion. Red edges and tip of the tongue with thin white or thin yellow coating, floating and rapid pulse. Clearing heat and removing toxin, expelling pathogen through the exterior. Modified Lonicera and Forsythia Powder. Lonicera 30g, Forsythia 15g, Dyers Woad Leaf 30g, Isatis Root 30g, Great Burdock Achene 10g, Liquorice Root 6g, Mint 6g, Smallpox Powder 15g. For vomiting with phlegm, add Bamboo Juice 10ml; for somnolence, add Acorus 12g, Curcuma Root 12g, Milkwort Root 6g; for dampness pathogen, heavy body and lack of strength, stuffiness with greasy coating, add Patchouli 12g, Fortune Eupatorium 12g.
2. Blazing of Both Qi and Nutrient (Encephalopathic T︰Severe headache, neck stiffness, dysphoria, delirious speech, unconsciousness or apathy, destructive and aggressive behavior, severe constipation, vomiting. Red tongue with yellow and rough coating, thready and rapid pulse. Clearing both qi and nutrient aspects, orifice-opening for resuscitation. Modified Nutrient-Clearing Decoction combined with Purple Snow Bolus. Isatis Leaf 30g, Unprocessed Rehmannia Root 20g, Raw Gypsum 30g, Ophiopogon Tuber 10g, Raw Rhubarb Rhizome 10g, Lonicera 15g, Salvia 10g, Anemarrhena 10g, Coptis Rhizome 6g. For excessive phlegm, add Bamboo Shavings 10g, Bile Arisaema 10g, Tabasheer 12g; for delirious speech, include Peaceful Palace Bovine Bezoar Pill 1 pill (dissolved and taken).
3. Dampness-heat︰Low-grade fever, sudden paralysis of the limbs, sensory loss, flaccidity of tendons and vessels, chest tightness and stuffiness, anorexia with reduced food intake, dry skin, edema in both lower limbs, dysuria or incontinence. Red tongue with yellow greasy coating, slippery and rapid pulse. Clear heat and drain dampness, promote water flow and unblock collaterals. Modified Three-Marvel Powder. Atractylodes Rhizome 12g, Achyranthes Root 15g, Phellodendron Bark 12g, raw Coix Seed 20g, Hypoglaucous Yam 10g, Alisma 10g, Chinese Angelica 10g, Red Peony Root 10g, Earthworm 10g, Suberect Spatholobus Stem 15g, Liquorice Root 6g. For limb paralysis, add Dipsacus 15g, Chinese Taxillus Herb 15g; for cognitive decline, add black sesame 10g, Sharpleaf Galangal Fruit 10g, Solomonseal Rhizome 10g, Desertliving Cistanche 10g; for urinary retention, add Plantain Herb 15g, Chinese waxgourd peel 20g, Polyporus 15g; for urinary incontinence, add mantis egg-case 10g, Sharpleaf Galangal Fruit 10g, and remove Hypoglaucous Yam and Alisma.
4. Liver-kidney Yin Deficiency︰Numbness, pain, and weakness in the lower limbs, or even paralysis of the limbs, muscle spasms, dizziness, tinnitus, dry skin without sweating or scant sweating, difficulty urinating or urinary incontinence, severe constipation. The tongue is red, dry, and lacks moisture with scant coating; the pulse is thready and rapid. Tonify the liver and kidneys, enrich yin, and unblock the collaterals. Modified Anemarrhena, Phellodendron, and Rehmannia Pill: Anemarrhena 10g, Phellodendron Bark 10g, Unprocessed Rehmannia Root 30g, Moutan Bark 10g, Poria 15g, Chinese Yam 15g, Alisma 10g, Eucommia Bark 15g, Chinese Taxillus Herb 15g, Barbary Wolfberry Fruit 15g, Pig Marrow 20g. If there is deficiency of both the lungs and kidneys, presenting with limb weakness, difficulty breathing, faint low voice, palpitations, and bluish lips, use Modified Four Ingredients Decoction: Prepared Rehmannia Root 15g, Peony Root 10g, Chinese Angelica 12g, Sichuan Lovage Rhizome 10g, Ginseng 10g, Glehnia 10g, Achyranthes Root 15g. For incontinence of urine and stool, add Songaria Cynomorium Herb 10g, Stir-fried White Atractylodes Rhizome 10g, Dipsacus 10g.
5. Blood Deficiency︰Blurred vision, eye swelling and pain, headache or migraine, decreased vision, or even complete blindness within hours or days. Dry eyes, dizziness, tinnitus, sore waist and weak legs, or lower limb paralysis. Red tongue with little coating, thin and weak pulse. Nourishing blood and improving vision, nourishing water to moisten wood. Improving vision with modified Bushen Tang. Chinese Angelica 12g, Prepared Rehmannia Root 20g, Barbary Wolfberry Fruit 12g, Flatstem Milkvetch Seed 12g, Chrysanthemum Flower 10g, Buerger Pipewort Flower 12g, Eucommia Bark 12g, Sichuan Dipsacus 15g, Achyranthes Root 15g, Sichuan Dipsacus 10g, Tortoise Carapace 12g, Desertliving Cistanche 12g. For severe sore waist and weak legs, add Cervi Deer-Horn Glue 10g, Floweringquince Fruit 12g; for flaccid muscles and tendons, add Tangshen 30g, Astragalus Root 15g; for muscle and tendon spasms, add Peony Root 30g, Stiff Silkworm 15g, Gastrodia Tuber 10g; for difficulty urinating, add Cassia Bark 6g, Dodder Seed 15g, Plantain Seed 10g.