Background: Acute disseminated encephalomyelitis (ADEM) is a demielination disease of the central nervous system (CNS) in response to previous infection or immunizations that occur acute, monofasic. ADEM generally occurs in children and young adults, rarely in middle-aged or elderly. Case report: We present a woman 46 years old with chief complaint of headache since 7 months ago, weakness of both legs, sudden loss of vision in both eyes since 3 days after weakness of both legs. There was no history of infection or previous vaccination. Brain and whole spine MRI were performed. Initial therapy methylprednisolone does not show improvement, then continued with administration of intravenous immunoglobulin. After 6 months, clinical improvements were obtained and no new lesions of the imaging. Conclusion: In this case report it is presented a case of ADEM in adult without a history of infection who recovered after intravenous immunoglobulin. Then that is still the current question, whether ADEM in the adult can be occur without preceded infection history? Keywords: ADEM, adult woman, history of infection.