Acute Disseminated Encephalomyelitis Responsive to Cyclophosphamide Therapy: A Case Report
Bibliographic record
Abstract
Acute disseminated encephalomyelitis (ADEM) is a rare neurologic condition that affects the central nervous system (CNS). In this report, a 22-year-old fraternal twin male developed ADEM 6 months post viral infection. He presented non-verbal with doll’s eyes, a right facial droop, right-sided upper and lower extremity weakness, as well as brisk reflexes and clonus on the right. He failed to improve with traditional therapies such as intravenous steroids, intravenous immunoglobulin, and plasmapheresis. However, 2 days following a 3-day course of intravenous cyclophosphamide 1,000 mg/m 2 , he spontaneously opened his eyes, developed masticatory movements, mouthed words, and regained movement in his extremities against gravity. There was a 40.7% and 16.6% decrease in lesion area in brain magnetic resonance imaging (MRI) T2 FLAIR sagittal and axial images, respectively over that 2-day period. This is the first reported case that shows neurological improvement, measured by the functional independence measure (FIM) scale, in addition to decreased lesion size on brain MRI T2 FLAIR images after implementation of cyclophosphamide therapy. Cyclophosphamide should be considered as an alternative therapy in patients with refractory ADEM. J Med Cases. 2015;6(7):290-294 doi: https://doi.org/10.14740/jmc2176w
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.050 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".