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| __NOTOC__ | | __NOTOC__ |
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| {{Acute disseminated encephalomyelitis}} | | {{Acute disseminated encephalomyelitis}} |
| {{CMG}}; {{AE}} | | {{CMG}}; {{AE}} {{Sujaya}} {{SHM}} |
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| '''''Synonyms and Keywords:''''' post infectious [[encephalomyelitis]]; [[Autoimmune]] [[demyelinating disease]] of [[central nervous system]] | | '''''Synonyms and Keywords:''''' post infectious [[encephalomyelitis]]; [[Autoimmune]] [[demyelinating disease]] of [[central nervous system]] |
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| ==[[Acute disseminated encephalomyelitis historical perspective|Historical Perspective]]== | | ==[[Acute disseminated encephalomyelitis historical perspective|Historical Perspective]]== |
| == [[Acute disseminated encephalomyelitis classification|Classification]]== | | ==[[Acute disseminated encephalomyelitis classification|Classification]]== |
| ==[[Acute disseminated encephalomyelitis pathophysiology|Pathophysiology]]== | | ==[[Acute disseminated encephalomyelitis pathophysiology|Pathophysiology]]== |
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| ==Overview==
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| The exact pathogenesis of [disease name] is not fully understood.
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| OR
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| It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
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| OR
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| [Pathogen name] is usually transmitted via the [transmission route] route to the human host.
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| OR
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| Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
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| OR
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| [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
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| OR
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| The progression to [disease name] usually involves the [molecular pathway].
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| OR
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| The pathophysiology of [disease/malignancy] depends on the histological subtype.
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| The actual mechanism of ADEM is unknown, however it is assumed to be caused by inflammation in genetically predisposed individuals provoked by an environmental stimulation (e.g., immunization or viral illness).
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| <br />
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| ==Pathophysiology==
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| ===Physiology===
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| The normal physiology of [name of process] can be understood as follows:
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| ===Pathogenesis===
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| *The exact pathogenesis of [disease name] is not completely understood.
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| OR
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|
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| *It is understood that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
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| *[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
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| *Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
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| *[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
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| *The progression to [disease name] usually involves the [molecular pathway].
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| *The pathophysiology of [disease/malignancy] depends on the histological subtype.
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|
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| ==Genetics==
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| [Disease name] is transmitted in [mode of genetic transmission] pattern.
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| OR
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| Genes involved in the pathogenesis of [disease name] include:
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| *[Gene1]
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| *[Gene2]
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| *[Gene3]
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| OR
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| The development of [disease name] is the result of multiple genetic mutations such as:
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| *[Mutation 1]
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| *[Mutation 2]
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| *[Mutation 3]
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| ==Associated Conditions==
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| Conditions associated with [disease name] include:
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| *[Condition 1]
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| *[Condition 2]
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| *[Condition 3]
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| ==Gross Pathology==
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| On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
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| ==Microscopic Pathology==
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| On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
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| ==[[Acute disseminated encephalomyelitis causes|Causes]]== | | ==[[Acute disseminated encephalomyelitis causes|Causes]]== |
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| ==Overview==
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| Disease name] may be caused by [cause1], [cause2], or [cause3].
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| OR
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| Common causes of [disease] include [cause1], [cause2], and [cause3].
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| OR
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| The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
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| OR
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| The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.
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| ==Causes==
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| *Symptom/manifestation] include [cause1], [cause2], and [cause3].
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| *[Cause] is a life-threatening cause of [disease].
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| ===Common Causes===
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| Common causes of [disease name] may include:
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| *[Cause1]
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| *[Cause2]
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| *[Cause3]
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| ==[[Acute disseminated encephalomyelitis differential diagnosis|Differentiating Acute disseminated encephalomyelitis from other Diseases]]== | | ==[[Acute disseminated encephalomyelitis differential diagnosis|Differentiating Acute disseminated encephalomyelitis from other Diseases]]== |
| Overview
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| [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3]. | | ==[[Acute disseminated encephalomyelitis epidemiology and demographics|Epidemiology and Demographics]]== |
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| OR
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| [Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
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| Differentiating [Disease name] from other Diseases
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| [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
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| OR
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| [Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].
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| OR
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| As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
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| Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]
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| On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].
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| {|
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| |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
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| ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
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| | colspan="6" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
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| ! colspan="7" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Para-clinical findings
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| | colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
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| ! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
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| |-
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| | colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
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| ! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
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| |-
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| ! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
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| ! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
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| ! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
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| |-
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptom 1
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| ! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptom 2
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptom 3
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical exam 1
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| ! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical exam 2
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical exam 3
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab 1
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab 2
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab 3
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging 1
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging 2
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| ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging 3
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| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| | style="background: #F5F5F5; padding: 5px;" |
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| |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
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| !Diseases
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| !Symptom 1
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| ! colspan="1" rowspan="1" |Symptom 2
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| !Symptom 3
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| !Physical exam 1
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| ! colspan="1" rowspan="1" |Physical exam 2
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| !Physical exam 3
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| !Lab 1
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| !Lab 2
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| !Lab 3
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| !Imaging 1
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| !Imaging 2
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| !Imaging 3
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| !Histopathology
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| |'''Gold standard'''
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| !Additional findings
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| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
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| |-
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
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| | style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 6
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| |}
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| ==References==
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| {{Reflist|2}}
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| {{WH}}
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| {{WS}}
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| [[Category: (name of the system)]] | | [[Category: (name of the system)]] |
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| ==[[Acute disseminated encephalomyelitis epidemiology and demographics|Epidemiology and Demographics]]==
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| <br />
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| ===Incidence===
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|
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| *The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
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| *In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
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| ===Prevalence===
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|
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| *The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
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| *In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
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| *The prevalence of [disease/malignancy] is estimated to be [number] cases annually.
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| ===Case-fatality rate/Mortality rate===
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|
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| *In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
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| *The case-fatality rate/mortality rate of [disease name] is approximately [number range].
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| ===Age===
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| *Patients of all age groups may develop [disease name].
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| *The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
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| *[Disease name] commonly affects individuals younger than/older than [number of years] years of age.
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| *[Chronic disease name] is usually first diagnosed among [age group].
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| *[Acute disease name] commonly affects [age group].
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| ===Race===
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|
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| *There is no racial predilection to [disease name].
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| *[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
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| ===Gender===
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| *[Disease name] affects men and women equally.
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| *[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
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| ===Region===
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|
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| *The majority of [disease name] cases are reported in [geographical region].
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| *[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
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| ===Developed Countries===
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| ===Developing Countries===
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| ==[[Acute disseminated encephalomyelitis risk factors|Risk Factors]]== | | ==[[Acute disseminated encephalomyelitis risk factors|Risk Factors]]== |
| <br />
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| ==Overview==
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| There are no established risk factors for [disease name].
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| OR
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| The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
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|
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| OR
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|
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| Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
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| OR
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| Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
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|
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| ==Risk Factors==
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| There are no established risk factors for [disease name].
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|
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| OR
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|
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| The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
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|
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| OR
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|
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| Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
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|
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| ===Common Risk Factors===
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|
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| *Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
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| *Common risk factors in the development of [disease name] include:
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| **[Risk factor 1]
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| **[Risk factor 2]
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| **[Risk factor 3]
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|
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| ===Less Common Risk Factors===
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|
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| *Less common risk factors in the development of [disease name] include:
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| **[Risk factor 1]
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| **[Risk factor 2]
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| **[Risk factor 3]
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|
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| ==[[Acute disseminated encephalomyelitis screening|Screening]]== | | ==[[Acute disseminated encephalomyelitis screening|Screening]]== |
|
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| ==Overview==
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| There is insufficient evidence to recommend routine screening for [disease/malignancy].
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|
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| OR
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|
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| According to the [guideline name], screening for [disease name] is not recommended.
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|
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| OR
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|
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| According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
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|
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| ==Screening==
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| There is insufficient evidence to recommend routine screening for [disease/malignancy].
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|
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| OR
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|
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| According to the [guideline name], screening for [disease name] is not recommended.
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|
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| OR
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|
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| According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with:
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|
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| *[Condition 1]
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| *[Condition 2]
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| *[Condition 3]
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|
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| ==[[Acute disseminated encephalomyelitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== | | ==[[Acute disseminated encephalomyelitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ==Overview==
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| If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
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| Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
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| Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
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| ==Natural History, Complications, and Prognosis==
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| ===Natural History===
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| *The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
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| *The symptoms of (disease name) typically develop ___ years after exposure to ___.
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| *If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
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| ===Complications===
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| *Common complications of [disease name] include:
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| **[Complication 1]
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| **[Complication 2]
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| **[Complication 3]
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| ===Prognosis===
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| *Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
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| *Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
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| *The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
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| *[Subtype of disease/malignancy] is associated with the most favorable prognosis.
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| *The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
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| ==Diagnosis== | | ==Diagnosis== |
| [[Acute disseminated encephalomyelitis history and symptoms|History and Symptoms]] | [[Acute disseminated encephalomyelitis physical examination|Physical Examination]] | [[Acute disseminated encephalomyelitis laboratory findings|Laboratory Findings]] | [[Acute disseminated encephalomyelitis electrocardiogram|Electrocardiogram]] | [[Acute disseminated encephalomyelitis x ray|X Ray]] | [[Acute disseminated encephalomyelitis CT|CT]] | [[Acute disseminated encephalomyelitis MRI|MRI]] | [[Acute disseminated encephalomyelitis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Acute disseminated encephalomyelitis other imaging findings|Other Imaging Findings]] | [[Acute disseminated encephalomyelitis other diagnostic studies|Other Diagnostic Studies]] | | [[Acute disseminated encephalomyelitis history and symptoms|History and Symptoms]] | [[Acute disseminated encephalomyelitis physical examination|Physical Examination]] | [[Acute disseminated encephalomyelitis laboratory findings|Laboratory Findings]] | [[Acute disseminated encephalomyelitis electrocardiogram|Electrocardiogram]] | [[Acute disseminated encephalomyelitis x ray|X Ray]] | [[Acute disseminated encephalomyelitis CT|CT]] | [[Acute disseminated encephalomyelitis MRI|MRI]] | [[Acute disseminated encephalomyelitis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Acute disseminated encephalomyelitis other imaging findings|Other Imaging Findings]] | [[Acute disseminated encephalomyelitis other diagnostic studies|Other Diagnostic Studies]] |
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| ===Diagnostic Study of Choice===
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| The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
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| The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
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| OR
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| The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
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| OR
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| There are no established criteria for the diagnosis of [disease name].
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| ===History and Symptoms===
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| The majority of patients with [disease name] are asymptomatic.
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| The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
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| ===Physical Examination===
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| Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
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| Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
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| The presence of [finding(s)] on physical examination is diagnostic of [disease name].
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| The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
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| ===Laboratory Findings===
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| An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
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| Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
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| [Test] is usually normal among patients with [disease name].
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| Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
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| There are no diagnostic laboratory findings associated with [disease name].
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| ===Electrocardiogram===
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| There are no ECG findings associated with [disease name].
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| An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| ===X-ray===
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| There are no x-ray findings associated with [disease name].
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| An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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| ===Echocardiography or Ultrasound===
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| There are no echocardiography/ultrasound findings associated with [disease name].
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| OR
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| Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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| ===CT scan===
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| There are no CT scan findings associated with [disease name].
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| [Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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| ===MRI===
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| There are no MRI findings associated with [disease name].
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| [Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| OR
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| There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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| ===Other Imaging Findings===
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| There are no other imaging findings associated with [disease name].
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| [Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| ===Other Diagnostic Studies===
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| There are no other diagnostic studies associated with [disease name].
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| [Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
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| ==Treatment== | | ==Treatment== |
| [[Acute disseminated encephalomyelitis medical therapy|Medical Therapy]] | [[Acute disseminated encephalomyelitis surgery|Surgery]] | [[Acute disseminated encephalomyelitis primary prevention|Primary Prevention]] | [[Acute disseminated encephalomyelitis secondary prevention|Secondary Prevention]] | [[Acute disseminated encephalomyelitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Acute disseminated encephalomyelitis future or investigational therapies|Future or Investigational Therapies]] | | [[Acute disseminated encephalomyelitis medical therapy|Medical Therapy]] | [[Acute disseminated encephalomyelitis surgery|Surgery]] | [[Acute disseminated encephalomyelitis primary prevention|Primary Prevention]] | [[Acute disseminated encephalomyelitis secondary prevention|Secondary Prevention]] | [[Acute disseminated encephalomyelitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Acute disseminated encephalomyelitis future or investigational therapies|Future or Investigational Therapies]] |
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| ==Case Studies== | | ==Case Studies== |
| [[Acute disseminated encephalomyelitis case study one|Case #1]] | | [[Acute disseminated encephalomyelitis case study one|Case #1]] |
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| ==Acknowledgements==
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| The content on this page was first contributed by: ELLISON L. SMITH, M.D.
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| ==Related Chapters== | | ==Related Chapters== |