Ewha Med J.  2003 Jun;26(2):97-103. 10.12771/emj.2003.26.2.97.

Clinical Manifestation of Acute Disseminated Encephalomyelitis in Children

• Cho SJ
• Park EA
• Yoo ES
• Kim HS
• Sohn SJ
• Seo JW
• Lee SJ
• Han HJ

• KMID: 2352860
• DOI: http://doi.org/10.12771/emj.2003.26.2.97

Abstract

OBJECTIVE
Acute disseminated encephalomyelitis(ADEM) is an acute demyelinating autoimmune inflammatory disease of the central nervous system which develops after infection of vaccination. It may be fatal, and produce a permanent residual static disability or fully recover. We retrospectively studied 14 cases to investigate the clinical findings and outcome of ADEM.
METHODS
14cases of ADEM diagnosed at Ewha Womans University Mokdong Hospital from 1998 to 2003 were retrospectively reviewed.
RESULTS
The age of onset was 5 years+/-7.8 months and no seasonal clustering was found. The time of onset of symptoms was between 3 to 30 days. The preceding events were nonspecific upper respiratory infections in 9 cases, aseptic meningitis in 4 cases, and gastroenteritis in one case. The initial symptoms were seizure, altered consciousness, hemiparesis, fever, headache, and vomiting. Brain MRI showed multifocal high signal intensity lesions on T2 weighted image mainly in the cerebral whith matter, basal ganglia and periventricular white matter. EEG was performed in some cases and showed generalized or focal slow waves and only one case showed focal spikes. Patients were treated with IV globulin and methylprednisolone and the symptoms improved within 3-7 days after treatment. All patients were followed up for more than 2 months and most of them fully recovered except two.
CONCLUSION
ADEM presents in various clinical manifestations depending on its involvement of the brain lesions. Most cases recovered fully but in some cases, residual permanent neurologic sequelae remained.

Keyword

Acute disseminated encephalomyelits; Children; ADEM

MeSH Terms

Age of Onset
Basal Ganglia
Brain
Central Nervous System
Child*
Cluster Analysis
Consciousness
Electroencephalography
Encephalomyelitis, Acute Disseminated*
Female
Fever
Gastroenteritis
Headache
Humans
Magnetic Resonance Imaging
Meningitis, Aseptic
Methylprednisolone
Paresis
Respiratory Tract Infections
Retrospective Studies
Seasons
Seizures
Vaccination
Vomiting
Methylprednisolone