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A 38-year-old lady presented with a two-week history of intermittent headache. She subsequently developed features of depression and cognitive decline. She had no focal neurological deficits. She was initially treated as a case of depression with pseudodementia. A diagnosis of acute disseminated encephalomyelitis (ADEM) was made later based on MRI brain and evoked potential studies. She was treated with intravenous methylprednisolone at a dose of 1 gram/day for three days, with which she made a good clinical recovery. This unusual presentation of ADEM is reported and the relevant literature reviewed.