Clinical and radiological features of recurrent demyelination following acute disseminated encephalomyelitis (ADEM)

Multiple Sclerosis and Related Disorders
Sanduni KariyawasamMing Lim

Abstract

To identify clinical and radiological features of children that relapse following an initial presentation of acute disseminated encephalomyelitis (ADEM). Clinical records and neuroimaging of children under the age of 16 years presenting with ADEM to a pediatric neurology referral center between 2006 and 2010 were evaluated. Of the 32 children with ADEM, 24 (7 female) with a median age of 4.8 (range 3-15) had a monophasic course. Eight patients (25%; 4 female) with median age of 6.9 (range 3-16) had relapsing demyelination; 3 relapsing within the 3 month interval (still defined within a monophasic event); 4 with multiphasic disseminated encephalomyelitis (MDEM), and 1 with non-multiple sclerosis recurrent demyelination. Clinical features at presentation could not distinguish the monophasic from the relapsing group. Infratentorial imaging changes (brain stem and cerebellar) were seen more frequently in the relapsing group (8/8 vs. 20/24), although differences were not statistically significant. At relapse, seven of the eight patients had clinical and radiologic infratentorial syndromes involving brainstem and/or cerebellum. Only one patient had more than one relapse. After a median follow up of 27 months (range 0-96) across the w...Continue Reading

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Citations

Nov 21, 2015·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Chiara TrabattiSalvatore Savasta
Jun 29, 2017·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Walter VerrusioM Cacciafesta

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