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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

Severe acute disseminated encephalomyelitis: a paediatric intensive care population-based study

M Absoud1, R C Parslow, E Wassmer

  • 1Institute of Child Health, Birmingham Children's Hospital, Birmingham, UK. michaelabsoud@childdemyelination.org.uk

Multiple Sclerosis (Houndmills, Basingstoke, England)
|September 30, 2010
PubMed

Insights

This study estimates the incidence of severe acute disseminated encephalomyelitis (ADEM) in UK pediatric intensive care units (PICUs) at 0.5 per million children annually. It highlights key clinical features and management of childhood ADEM cases requiring PICU admission.

Area of Science:

  • Pediatric Neurology
  • Epidemiology
  • Critical Care Medicine

Background:

  • Severe acute disseminated encephalomyelitis (ADEM) is a rare neurological disorder in children.
  • Limited epidemiological data exists for pediatric ADEM, particularly for severe cases requiring intensive care.

Purpose of the Study:

  • To determine the epidemiology and clinical characteristics of children with ADEM admitted to pediatric intensive care units (PICUs) in England and Wales.
  • To estimate the incidence of severe childhood ADEM requiring PICU admission.

Main Methods:

  • A population-based study using anonymized data from the Paediatric Intensive Care Audit Network (PICANet) from 2004-2008.
  • Inclusion criteria: children under 16 years with ADEM diagnosis admitted to 25 PICUs.
  • Data supplemented by the Office for National Statistics (ONS) mortality database.

Main Results:

  • 27 cases of ADEM admitted to PICUs were identified via PICANet, with 3 additional deaths identified via ONS.
  • Median age was 4.8 years; common clinical features included unspecified encephalopathy (100%), seizures (18.5%), and polyfocal neurological deficits (22.2%).
  • Estimated incidence of childhood ADEM requiring PICU admission in England and Wales is 0.5 per million children/year.

Conclusions:

  • Childhood ADEM requiring PICU admission has an estimated incidence of 0.5 per million children/year in England and Wales.
  • The study provides crucial epidemiological insights into severe pediatric ADEM.
  • Clinical management involved mechanical ventilation and inotropic support; plasmapheresis was not utilized in this cohort.

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