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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

Long-term prognosis of pediatric patients with relapsing acute disseminated encephalomyelitis

Soe Mar1, Jason Lenox, Tammie Benzinger

  • 1Department of Pediatric and Developmental Neurology, Washington University School of Medicine, St Louis, Missouri 63110, USA. mars@neuro.wustl.edu

Journal of Child Neurology
|October 8, 2009
PubMed

Insights

Children diagnosed with acute disseminated encephalomyelitis (ADEM) using strict criteria have a good long-term prognosis. Even with relapses, the risk of developing multiple sclerosis is low, indicating a generally benign outcome.

Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Demyelinating Diseases

Background:

  • Long-term prognosis data for acute disseminated encephalomyelitis (ADEM) are inconsistent due to varied definitions.
  • Standardized criteria are needed to accurately assess the long-term outcomes of pediatric ADEM.

Purpose of the Study:

  • To determine the long-term prognosis of pediatric acute disseminated encephalomyelitis (ADEM) using strict International Pediatric Multiple Sclerosis Study Group criteria.
  • To specifically evaluate the prognosis of relapsing cases within this cohort.

Main Methods:

  • Retrospective analysis of 86 children with a first central nervous system inflammatory demyelinating disease event.
  • Strict application of International Pediatric Multiple Sclerosis Study Group criteria for ADEM diagnosis.
  • Long-term follow-up, averaging 9.2 years for all ADEM patients and 12.8 years for relapsing cases.

Main Results:

  • 33 patients (38%) met the criteria for ADEM, with 9 experiencing relapses.
  • The overall risk of relapse was 27%.
  • The risk of developing multiple sclerosis from ADEM was low at 6%; all relapsing cases showed a benign course despite initial relapses.

Conclusions:

  • Strict diagnostic criteria for pediatric ADEM are crucial for consistent prognostic evaluation.
  • Pediatric ADEM, even with relapses, generally follows a benign long-term course with a low risk of developing multiple sclerosis.
  • Prolonged follow-up confirms favorable outcomes for children diagnosed with ADEM.

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