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Acute Disseminated Encephalomyelitis in Children and Adolescents: A Multicenter Retrospective Study of Relapse and

Seda Kanmaz1, Sanem Yılmaz1, Nihal Olgaç Dündar2

  • 1Faculty of Medicine, Department of Pediatric Neurology, Ege University, Izmir, Turkey.

Journal of Child Neurology
|May 9, 2025
PubMed

Insights

This study on acute disseminated encephalomyelitis found that anti-myelin oligodendrocyte glycoprotein antibody status did not impact relapse risk or recovery. Certain initial symptoms predict outcomes in pediatric ADEM patients.

Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Demyelinating Diseases

Background:

  • Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disease of the central nervous system.
  • Understanding factors influencing ADEM prognosis is crucial for patient management.
  • The role of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies in ADEM outcomes requires further clarification.

Purpose of the Study:

  • To investigate demographic, clinical, laboratory, and prognostic data in children with ADEM.
  • To evaluate the association between anti-MOG antibody status and ADEM outcomes, including relapse and recovery.
  • To identify clinical predictors of relapse and incomplete recovery in pediatric ADEM.

Main Methods:

  • Retrospective analysis of 245 pediatric ADEM patients from 24 centers (2010-2022).
  • Assessment of short- and long-term outcomes: disease severity, course, clinical relapse, and recovery rates.
  • Univariant and multivariant analyses to determine predictors of outcome, with incomplete recovery defined as modified Rankin Score ≥1 or epilepsy.

Main Results:

  • ADEM typically presents in early childhood (mean age 6.3 years).
  • Relapse occurred in 12.6% of patients; predictors included sex, visual impairment, and ataxia.
  • Incomplete recovery (23.3%) was linked to seizures and ICU admission; anti-MOG positivity showed no association with relapse or incomplete recovery.

Conclusions:

  • The study supports the generally monophasic nature of ADEM with a high recovery rate in children.
  • Initial clinical presentation, including specific symptoms like seizures and ataxia, can help predict ADEM outcomes.
  • Anti-MOG antibody status does not appear to be a significant factor in ADEM relapse or recovery in this cohort.

Keywords:
autoimmuneencephalitisneuroimmunologyoutcome

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