J Korean Child Neurol Soc.
2000 Dec;8(2):297-302.
MRI Diagnosis of Acute Disseminated Encephalomyelitis (ADEM): Clinical Characteristics Based on the Lesion of Distribution
- Affiliations
-
- 1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea.
- 2Department of Radiology, College of Medicine, Seoul National University, Seoul, Korea.
Abstract
- PURPOSE
Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of
the central nervous system preceded by viral illnesses or vaccinations. Diagnosis depends on
the clinical manifestations and the neuroimaging findings. The authors analyzed
the clinical differences according to the extent and distribution of lesions on brain MRI.
METHODS
We studied 24 ADEM patients diagnosed by clinical and radiologic findings
from 1990 to 1999. We classified the MRI findings as follows. W group : Multifocal lesions
only in the white matter; G group : Lesions in the deep gray matter with or without
in the white matter. Neurologic findings, clinical courses, outcomes were compared between
the 2 groups.
RESULTS
Nine of 12 (75%) and 7 of 12 (58%) had altered mentality in W group and G
group respectively. Five of 12 (42%) and 3 of 12 (25%) had seizures in W group and G
group respectively. Other neurological manifestations were as follows : Pyramidal tract signs,
motor disturbances, facial palsy and ataxia. Ten of 12 (83%) and 11 of 12 (92%) showed
clinical improvement in W group and G group respectively. Median recovery times were
29 days in W group and 24 days in G group. Seven of 12 and 9 of 12 were recovered
completely without neurological sequelae.
CONCLUSION
Although there was no statistically significant difference, ADEM may be
a group of heterogeneous disorders, since the clinical and radiological manifestations are
quite diverse. Caution should be made on the MRI distribution of lesions need to be
considered in the diagnosis of the patients who are suspected as having ADEM.