Related Experiment Video
Updated: Jul 30, 2026
Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
Childhood acute disseminated encephalomyelitis: an Egyptian pilot study
Hamed Ahmed Elkhayat1, Omnia Fathy El-Rashidy1, Iman Ali Elagouza2
1Faculty of Medicine, Paediatrics Department, Ain Shams University, Cairo, Egypt.
Insights
Acute disseminated encephalomyelitis (ADEM) in children presents with varied symptoms and requires prompt treatment. Steroids are more effective than IVIG for treating ADEM, leading to better outcomes and lesion resolution.
Area of Science:
- Pediatric Neurology
- Neuroimmunology
- Clinical Research
Background:
- Acute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating disorder affecting children, characterized by diverse clinical presentations.
- Understanding the clinical course, diagnostic markers, and treatment efficacy in pediatric ADEM is crucial for improving patient outcomes.
Purpose of the Study:
- To describe the clinical features, laboratory and neuroimaging findings, and treatment responses in children with ADEM.
- To evaluate the effectiveness of different treatment modalities, specifically pulsed methylprednisolone and intravenous immunoglobulin (IVIG).
- To investigate potential associations between ADEM and factors like vaccination history and hyponatremia.
Main Methods:
- Retrospective and prospective analysis of 21 pediatric patients diagnosed with ADEM.
- Clinical and radiological follow-up at 3-month intervals.
- Assessment of treatment outcomes based on clinical improvement and MRI lesion resolution.
Main Results:
- ADEM presented with variable neurological symptoms; MRI confirmed abnormalities in all patients.
- Corticosteroid treatment led to prompt improvement, while IVIG showed a high failure rate in initial treatment.
- Patients treated with steroids demonstrated significantly better outcomes, with more complete lesion resolution and fewer sequelae compared to untreated patients.
Conclusions:
- Pulsed corticosteroids are a superior treatment for pediatric ADEM compared to IVIG.
- Early diagnosis and effective treatment, particularly with steroids, are critical for favorable outcomes in ADEM.
- Further research is warranted to explore the link between ADEM, hyponatremia, and post-vaccination occurrences.
Abstract:
Describing the variable clinical features, laboratory findings, neuroimaging findings, and treatments given to children who presented with ADEM and following them up both clinically and radiologically. 21 patients were recruited: 14 new cases, and 7 old ones presenting over the preceding 5 years (retrospective review of existing data). 11 males and 10 females, with a mean age of 4.4 years ± 2.7 SD, were included. All new patients were subject to full history, examination and a panel of investigations including MRI of the brain. Treatment was given in the form of pulsed methyl prednisolone or intravenous immunoglobulin (IVIG), followed by clinical and radiological follow-up every 3 months as needed. 11 cases occurred in spring, 8 post vaccine, of which 5 were after oral polio vaccine (OPV). MRI was done for all 21 patients and was abnormal in all of them, CT was done in only 10 patients as was normal in 9. Hyponatremia was seen in 11 patients. All patients who received corticosteroids showed prompt improvement. 6 out of 10 patients who received IVIG first failed treatment. Of the 17 treated patients, 10 had no sequelae and 10 had total lesion resolution on MRI at 3 months, versus 1 and 0 patients, respectively, in the untreated group. We found a disproportionately large number of post vaccination cases, especially after OPV. The association of ADEM with hyponatremia needs further study. MRI is central to diagnosis. Outcome is much better with treatment with steroids being far superior to IVIG. Excess use of IVIG should be discouraged.
Related Concept Videos
01:25Arboviral Encephalitis
01:19Encephalitis l: Introduction
01:26Encephalitis ll: Pathophysiology