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Updated: May 10, 2026

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

Defining encephalopathy in acute disseminated encephalomyelitis

S E Fridinger1, Gulay Alper2

  • 1University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Journal of Child Neurology
|June 11, 2013
PubMed

Insights

Encephalopathy in pediatric acute disseminated encephalomyelitis is often subtle, with irritability and sleepiness being key indicators. These early signs are crucial for diagnosis in children, despite diagnostic challenges.

Area of Science:

  • Pediatric Neurology
  • Demyelinating Diseases
  • Neuroinflammation

Background:

  • Acute disseminated encephalomyelitis (ADEM) diagnosis requires encephalopathy per International Pediatric Multiple Sclerosis Study Group guidelines.
  • Existing literature inadequately defines encephalopathy's clinical features in pediatric ADEM.
  • Better characterization of mental status changes is needed for accurate pediatric ADEM diagnosis.

Purpose of the Study:

  • To define encephalopathy in pediatric ADEM by detailing mental status changes.
  • To identify specific encephalopathy-defining features in children with ADEM.
  • To compare clinical, CSF, and EEG findings based on encephalopathy severity.

Main Methods:

  • Retrospective chart review of 25 children diagnosed with ADEM.
  • Analysis of encephalopathy-defining features based on International Pediatric Multiple Sclerosis Study Group criteria.
  • Comparison of clinical, cerebrospinal fluid (CSF), and electroencephalography (EEG) data.

Main Results:

  • Encephalopathy features included irritability (36%), sleepiness (52%), confusion (8%), obtundation (20%), and coma (16%).
  • Seizures occurred in 28% of patients; 65% showed generalized slowing on EEG.
  • Irritability and/or sleepiness alone diagnosed encephalopathy in approximately 50% of cases.

Conclusions:

  • Irritability and sleepiness are significant, albeit subtle, indicators of encephalopathy in pediatric ADEM.
  • Accurate diagnosis of early encephalopathy signs in young children presents challenges due to their transient nature.
  • Further research is needed to refine diagnostic criteria for encephalopathy in pediatric demyelinating disorders.

Keywords:
acquired demyelinating syndromesacute disseminated encephalomyelitischildrenencephalopathy

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