Abstract
The authors report 6 children with the diagnosis of acute disseminated encephalomyelitis. Diagnosis was based on clinical and radiological findings. The most common presenting symptoms were fever and disturbed consciousness, followed by cranial nerve abnormalities and pyramidal signs. Brain MRI showed hyperintense signals on T2-weighted images, most commonly in the subcortical and periventricular white matter, brainstem, basal ganglia and thalamus. The lesions were bilateral, asymmetrical and highly variable in size and number. A preceding infection was present in 3 of 6 children. Early high-dose corticosteroids were given to all the patients. All patients recovered clinically. Follow-up ranged from 10 months to 2 years. No relapses were observed during this period. Early high-dose steroid therapy seems to be an effective treatment in acute disseminated encephalomyelitis.
References
Tselis AC, Lisak RP. Acute disemminated encephalomyelitis. In: Antel J, Birnbaum G, Hartung HP, eds. Clinical Neuroimmunology. Boston; Blackwell Science, 1998: 116–147.
Johnson RT. Postinfectious demyelinating diseases. In: Johnson RT, ed. Viral infections of the nervous system. 2nd ed. Philadelphia: Lippincott-Raven, 1998: 181–210.
Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: a long term follow-up study of 84 pediatric patients. Neurology 2002; 59: 1224–31.
Caldemeyer KS, Smith RR, Harris TM, Edwards MK. MRI in acute disseminated encephalomyelitis.Neuroradiology 1994; 36: 216–220.
Singh S, Alexander M, Korah IP. Acute disemminated encephalomyelitis: MR imaging features.AJR Am J Roentgenol 1999; 173: 1101–1107.
Straub J, Chofflon M, Delavelle J. Early high-dose intravenous methylprednisolone in acute disseminated encephalomyelitis: a successful recovery.Neurology 1997; 49: 1145–1147.
Apak RA, Kose G, Anlar B, Turanli G, Topaloglu H, Ozdirim E. Acute disseminated encephalomyelitis in childhood: report of 10 cases.J Child Neurol 1999; 14: 198–201.
Hynson JL, Kornberg AJ, Coleman LT, Shield L, Harvey AS, Kean MJ. Clinical and neuroradiological features of acute disseminated encephalomyelitis in children.Neurology 2001; 56: 1308–1312.
Dale RC, de Sousa C, Chong WKet al. Acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis and multiple sclerosis in children.Brain 2000; 123: 2407–2422.
Baum PA, Barkovich AJ, Koch TKet al. Deep grey matter involvement in children with acute disseminated encephalomyelitis.Am J Neuroradiol 1994; 15: 1275–1283.
Kanter DS, Horensky D, Sperling RAet al. Plasmapheresis in fulminant acute disseminated encephalomyelitis. Neurology 1995; 45: 824–827.
Sahlas DJ, Miller SP, Guerin M, Veilleux M, Francis G. Treatment of acute disseminated encephalomyelitis with intravenous immunoglobulins.Neurology 2000; 54: 1370–1372.
Pradhan S, Gupta RP, Shashank S, Pandey N. Intravenous immunoglobulin therapy in acute disseminated encephalomyelitis.J Neurol Sci 1999; 165: 56–61.
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Balu, R., Shanbag, P., More, V. et al. Acute disseminated encephalomyelitis. Indian J Pediatr 71, 1035–1038 (2004). https://doi.org/10.1007/BF02828122
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DOI: https://doi.org/10.1007/BF02828122