Laura Longo, Giuseppina Bonfiglio, Rossella Longo
Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated demyelinating disorder in children. While lower urinary tract dysfunction (LUTD) is estimated to affect up to 33% of patients, it is frequently overlooked in clinical reports, and specific rehabilitation strategies are still lacking. We describe a pediatric patient with ADEM presenting with paraplegia and an areflexic neurogenic bladder, managed with a structured rehabilitation protocol, including clean intermittent catheterization, afferent neuromodulation, and pelvic floor training. Progressive neurological and urinary recovery was achieved within 2 months. This case highlights the potential role of early multidisciplinary rehabilitation in promoting bladder recovery in ADEM.