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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
26:48

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis

Published on: July 4, 2007

Acute disseminated encephalomyelitis in children: focus on relapsing patients

Agnese Suppiej1, Roberta Vittorini, Marta Fontanin

  • 1Department of Pediatrics, University of Padua, Padua, Italy. suppiej@pediatria.unipd.it

Pediatric Neurology
|June 17, 2008
PubMed

Insights

Pediatric acute disseminated encephalomyelitis (ADEM) prognosis is uncertain. Early spinal fluid and visual-evoked potential findings may predict poor outcomes in children with ADEM.

Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Clinical Neuroscience

Background:

  • Pediatric acute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating disease.
  • Prognostic factors and diagnostic criteria for ADEM in children require further investigation.
  • Differentiating ADEM from other demyelinating disorders like multiple sclerosis is crucial for appropriate management.

Purpose of the Study:

  • To investigate prognostic factors for relapse in pediatric ADEM.
  • To evaluate diagnostic criteria for ADEM and related disorders in children.
  • To assess long-term outcomes and disease course in pediatric ADEM.

Main Methods:

  • Retrospective study of 24 Italian children diagnosed with ADEM.
  • Mean age at onset 6.9 years, mean follow-up 52.8 months.
  • Analysis of clinical, neurophysiologic, cerebrospinal fluid (CSF), and neuroradiologic data.

Main Results:

  • Most patients (22/24) met International Pediatric Multiple Sclerosis Study Group criteria for ADEM.
  • Three patients experienced relapses at 3 months, 2 years, and 8 years.
  • Early findings of oligoclonal IgG bands in CSF and persistent visual-evoked potential abnormalities correlated with poor outcomes.
  • No initial features predicted outcomes; however, revised McDonald criteria aided diagnosis by the second attack.

Conclusions:

  • Early prognostic indicators for pediatric ADEM include CSF oligoclonal bands and visual-evoked potential abnormalities.
  • Revised diagnostic criteria facilitate early identification of multiple sclerosis and multiphasic ADEM.
  • Long-term follow-up is essential to characterize the disease course in pediatric ADEM.

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