iarjimphIARJIMPHIARJIMPH2709-331Xhttps://doi.org/10.47310/iarjimph.2022.v03i02.017Diagnose SARS-CoV-2 Associated Acute, Disseminated Encephalomyelitis Only Using Appropriate CriteriaJosefFinstererTalalAlmasThis commentary evaluates the report by Oumerzouk et al. describing three cases of COVID-19–associated acute disseminated encephalomyelitis (ADEM). Although the cases are clinically interesting, significant concerns arise regarding the diagnostic certainty of ADEM due to limited and incomplete neuroimaging. MRI sequences essential for confirming ADEM, including T1, T2, ADC, PWI, and SWI, were not presented, and spinal imaging—crucial for identifying myelitis—was omitted. Several image descriptions were inconsistent or unconvincing, and hemorrhagic lesions in patient-2 more strongly suggest acute hemorrhagic necrotizing encephalitis (AHNE) rather than ADEM. Overall, inadequate imaging and application of diagnostic criteria limit the validity of the authors’ conclusions.