Abstract
Introduction: Acute disseminated encephalomyelitis (ADEM) is a monophasic autoimmune inflammatory demyelinating disease of the central nervous system that predominantly involves the white matter of the brain and spinal cord(1). It is a rare disease affecting both children and adults (2). In the majority of cases ADEM usually appears after vaccinations or viral/bacterial infections
Methods: This was a case study of two patients with ADEM presenting with dystonia. The study was conducted at King Khalid Hospital in Hail, Saudi Arabia.
Results: MRI studies showed subcortical white matter lesion in the right frontal region in patient 1, and a right thalamic lesion in patient 2.
Conclusion: We conclude that the lesions detected by the MRI were responsible for the limb dystonia. We believe that the lesions seriously disrupted the cortical-striatal pathways in the right cerebral hemisphere, leading to hemi-dystonia.

Key words: Acute Demyelinating Encephalomyelitis(ADEM), Dystonia