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Updated: Mar 25, 2026
Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
Long-term motor, cognitive and behavioral outcome of acute disseminated encephalomyelitis
Smadar Shilo1, Orli Michaeli2, Eli Shahar3
1Department of Pediatrics A, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Insights
Long-term follow-up of acute disseminated encephalomyelitis (ADEM) in children reveals significant neurocognitive deficits, even after apparent recovery. Older age and male gender are risk factors for severe outcomes.
Area of Science:
- Pediatric Neurology
- Neuroimmunology
Background:
- Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated demyelinating disease affecting the central nervous system in children.
- While many children recover, concerns remain regarding long-term neurological and cognitive sequelae.
Purpose of the Study:
- To assess the long-term motor and neurocognitive outcomes in children diagnosed with ADEM.
- To identify prognostic factors associated with severe neurological sequelae following ADEM.
Main Methods:
- A cohort of 43 children hospitalized with ADEM between 2002-2012 was retrospectively analyzed.
- Participants underwent comprehensive neurological examinations and detailed neurocognitive and behavioral assessments during follow-up.
Main Results:
- Over half (61%) of the children exhibited neurological sequelae after a mean follow-up of 5.5 years.
- Common impairments included attention-deficit hyperactivity disorder (44%), behavioral issues (32%), and learning disabilities (21%).
- A significant proportion (12%) had intellectual disability (full-scale IQ ≤ 70).
Conclusions:
- Neurocognitive deficits can persist even in children who appeared fully recovered at hospital discharge.
- Older age at diagnosis and male gender were identified as risk factors for more severe neurological outcomes.
- Routine neuropsychological testing and extended follow-up are recommended for all pediatric ADEM patients, irrespective of initial neurological status.
Objective:
The purpose of this study was to evaluate the long-term motor and neurocognitive outcome of children with acute disseminated encephalomyelitis and to identify prognostic risk factors.
Methods:
The study included 43 children who were hospitalized due to acute disseminated encephalomyelitis during the years 2002-2012. The children underwent full neurological examinations, along with comprehensive neurocognitive and behavioral assessments.
Results:
Twenty-six (61%) children had different degrees of neurological sequelae after a mean follow-up of 5.5 ± 3.5 years. The most common residual impairment included attention-deficit hyperactivity disorder (44%), behavioral problems (32%), and learning disabilities (21%). Five (12%) children had a full-scale IQ of 70 or less, compared to 2.2% in the general population.
Conclusions:
Neurocognitive sequelae were found even in children who were considered as fully recovered at the time of discharge. Risk factors for severe neurological sequelae were older age at diagnosis and male gender. We suggest neuropsychological testing and long-term follow-up for all children with acute disseminated encephalomyelitis, even in the absence of neurological deficits at discharge.
