Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children
Top Cited Papers
- 22 May 2001
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 56 (10), 1308-1312
- https://doi.org/10.1212/wnl.56.10.1308
Abstract
Objective: To identify the clinical and neuroradiologic features of acute disseminated encephalomyelitis (ADEM) in childhood. Methods: A retrospective review was conducted of the medical records and MRI of children who presented to the Royal Children’s Hospital in Melbourne with ADEM between January 1993 and December 1998. Results: Of the 31 patients included in this study, 22 (71%) experienced a prodromal illness. Two patients (6%) had received hepatitis B vaccine 3 to 6 weeks before developing their illness. Symptoms and signs typically evolved over several days. Ataxia was the most common presenting feature, occurring in 20 patients (65%). MRI findings were variable, but lesions were most commonly seen bilaterally and asymmetrically in the frontal and parietal lobes. The authors found a high incidence of the corpus callosal and periventricular changes more typically associated with MS, but they also found a high rate of deep gray matter involvement (61% of patients). The use of high-dose IV methylprednisolone was usually associated with rapid recovery. Eighty-one percent of patients recovered completely, with only mild sequelae recorded in the remaining children. Conclusion: In the absence of a biological marker, the distinction between ADEM and MS cannot be made with certainty at the time of first presentation, but the authors suggest that a viral prodrome, early-onset ataxia, high lesion load on MRI, involvement of the deep gray matter, and absence of oligoclonal bands are more indicative of ADEM.This publication has 16 references indexed in Scilit:
- Idiopathic inflammatory demyelinating diseases of the central nervous system: differentiating between acute disseminated encephalomyelitis and malignant multiple sclerosisJournal of Clinical Neuroscience, 1999
- Acute Disseminated Encephalomyelitis in Childhood: Report of 10 CasesJournal of Child Neurology, 1999
- Multiphasic disseminated encephalomyelitis presenting as alternating hemiplegia.Journal of Neurology, Neurosurgery & Psychiatry, 1995
- Consecutive cerebral MRI findings of acute relapsing disseminated encephalomyelitisPediatrics International, 1994
- MRI in acute disseminated encephalomyelitisNeuroradiology, 1994
- Large focal tumor‐like demyelinating lesions of the brain: Intermediate entity between multiple sclerosis and acute disseminated encephalomyelitis? A study of 31 patientsAnnals of Neurology, 1993
- Multiple sclerosis in childhood: Report of 15 casesBrain & Development, 1991
- MAGNETIC RESONANCE IMAGING OF INFLAMMATORY AND DEMYELINATING WHITE‐MATTER DISEASES OF CHILDHOODDevelopmental Medicine and Child Neurology, 1990
- Parainflammator Leukoencephalomyelitis: Clinical and Magnetic Resonance Imaging FindingsJournal of Child Neurology, 1988
- Multiple sclerosis in childhood: Clinical profile in 125 patientsThe Journal of Pediatrics, 1987