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[Acute disseminated encephalomyelitis in children].

R Erazo-Torricelli1

  • 1Servicio de Neurología Pediátrica, Hospital Luis Calvo Mackenna, Santiagode, Chile. ricardoerazo@yahoo.com

Revista De Neurologia
|April 28, 2006
PubMed
Summary

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disease usually affecting children after infection. Most patients experience a good outcome, but long-term follow-up is crucial for diagnosis.

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Area of Science:

  • Neurology
  • Immunology
  • Pediatrics

Context:

  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory-demyelinating disease.
  • ADEM typically follows an infection or vaccination and is more common in children.
  • This review synthesizes data from the last decade, including a local cohort of 42 patients.

Purpose:

  • To review clinical presentation, diagnostic methods, treatment strategies, and prognosis of ADEM.
  • To provide insights based on recent literature and clinical experience.
  • To highlight the diagnostic challenges and therapeutic approaches for ADEM.

Summary:

  • ADEM presents 2-30 days post-infection with neurological symptoms like altered consciousness (50-60%) and motor dysfunction (80-90%).
  • Magnetic resonance imaging is key for diagnosis, though clinico-neuroimaging discrepancies can occur.
  • Steroids are the primary treatment, effective in ~90% of cases; mortality is low (0-7%), with sequelae in 10-20%.

Impact:

  • ADEM is typically a monophasic demyelinating condition with a favorable prognosis.
  • Distinguishing ADEM from multiple sclerosis is important due to recurrence potential (10-30%).
  • Definitive diagnosis of ADEM relies on long-term patient follow-up.

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