[Acute disseminated encephalomyelitis in children]

Acute disseminated encephalomyelitis (ADEM) is a demyelinating autoimmune inflammatory disease of the central nervous system. It is most often seen in children a few days to several weeks after certain infections or vaccinations. Clinically, ADEM can hardly be distinguished from primary viral encephalitis. The diagnosis is most frequently established on the basis of characteristic findings on MRI of the brain. Mostly the disease seems to be self-limiting, but in untreated patients the mortality rate may be as high as 20% and the risk of permanent neurological deficits 10-33%. Treatment with glucocorticoids seems to be effective in the majority of patients and should at least be started in all patients with an affected level of consciousness. Treatment with intravenous immunoglobulin has recently been given in a few patients with apparent success.