Supplementary Material for: Multiphasic Acute Disseminated Encephalomyelitis (MDEM) with a Temporal Gap of 26 years; a Case Report with Novel Presentation

Acute Disseminated Encephalomyelitis (ADEM) is an acute autoimmune demyelinating disease of the central nervous system that typically follows an acute viral infection or post-vaccination. It is more common in children than in adults and is characterized by widespread demyelination of the white matter of the brain and spinal cord. ADEM typically presents as a monophasic illness. Multiphasic ADEM has been an emerging topic with case reports highlighting the importance of the need for further investigation and literature on this topic. Multiphasic ADEM in adults is a rare presentation with an atypical course that can cause a delay in diagnosis leading to disability in patients. Multiple case reports have shown the presence of Multiphasic ADEM without an established cause, emphasizing the importance of additional insight and data in this context. This is a unique case of Multiphasic ADEM in a 59-year-old male with a temporal gap of 26 years.