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[Acute disseminated encephalomyelitis in children]
1Servicio de Neurología Pediátrica, Hospital Luis Calvo Mackenna, Santiagode, Chile. ricardoerazo@yahoo.com
Revista De Neurologia
|April 28, 2006
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.
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.