This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Murthy, S. N. K.
Right arrow Articles by Bakshi, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Murthy, S. N. K.
Right arrow Articles by Bakshi, R.
Related Collections
Right arrow Infectious Disease & Immunity
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?
PEDIATRICS Vol. 110 No. 2 August 2002, pp. e21-e21

ELECTRONIC ARTICLE

Acute Disseminated Encephalomyelitis in Children

S. N. Krishna Murthy, MD*,{ddagger},§, Howard S. Faden, MD{ddagger},||, Michael E. Cohen, MD*,{ddagger},§ and Rohit Bakshi, MD*,¶,#

* Departments of Neurology
{ddagger} Pediatrics, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York
§ Divisions of Child Neurology
|| Infectious Diseases, Children’s Hospital of Buffalo, Buffalo, New York
Imaging Services
# Buffalo Neuroimaging Analysis Center, Jacobs Neurological Institute of Kaleida Health, Buffalo, New York

Objective. To describe the epidemiologic, clinical, neuroimaging, and laboratory features; treatment; and outcome in a cohort of children with acute disseminated encephalomyelitis (ADEM).

Methods. A 6-year retrospective chart review of children with the diagnosis of ADEM was conducted.

Results. Eighteen cases were identified. Sixteen patients (88%) presented in either winter or spring. Thirteen children (72%) had a recent upper respiratory tract illness. Patients presented most often with motor deficits (77%) and secondly with altered consciousness (45%). Spinal fluid abnormalities occurred in 70%. Despite rigorous microbiologic testing, a definite microbiologic diagnosis was established only in 1 child with Epstein-Barr virus disease and probable or possible diagnoses in 3 children with Bartonella henselae, Mycoplasma pneumoniae, or rotavirus disease. Brain magnetic resonance imaging identified lesions in the cerebral cortex in 80%, in subcortical white matter in 93%, in periventricular white matter in 60%, in deep gray matter in 47%, and in brainstem in 47% of patients. Eleven patients (61%) were treated with corticosteroids, and 2 were treated with intravenous immunoglobulins. All patients survived. Three patients (17%) had long-term neurologic sequelae.

Conclusions. Epidemiologic evidence from this study suggests an infectious cause for ADEM. The agent is most likely a difficult-to-diagnose winter/spring respiratory virus. Magnetic resonance imaging was the neuroimaging study of choice for establishing the diagnosis and for following the course of the disease. Prognosis for survival and outcome was excellent. Recurrent episodes of ADEM must be differentiated from multiple sclerosis.

Key Words: acute disseminated encephalomyelitis • ADEM • encephalitis • postinfectious encephalitis • encephalomyelitis

Abbreviations: ADEM, acute disseminated encephalomyelitis • CNS, central nervous system • MRI, magnetic resonance imaging • FLAIR, fluid-attenuated inversion recovery • PCR, polymerase chain reaction • EBV, Epstein-Barr virus • Ig, immunoglobulin • TR, repetition time • TE, echo time • NSA, number of signal averages • FOV, field of view • CT, computerized tomography • WBC, white blood cell • CSF, cerebrospinal fluid • IVIG, intravenous gammaglobulin • MS, multiple sclerosis

Received for publication Dec 18, 2001; Accepted Apr 8, 2002.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 J Child NeurolHome page
E. M. Yiu, A. J. Kornberg, M. M. Ryan, L. T. Coleman, and M. T. Mackay
Acute Transverse Myelitis and Acute Disseminated Encephalomyelitis in Childhood: Spectrum or Separate Entities?
J Child Neurol, March 1, 2009; 24(3): 287 - 296.
[Abstract] [PDF]

Home page
 NeurologyHome page
D. Pohl, E. Waubant, B. Banwell, D. Chabas, T. Chitnis, B. Weinstock-Guttman, S. Tenembaum, and for the International Pediatric MS Study Group
Treatment of pediatric multiple sclerosis and variants
Neurology, April 17, 2007; 68(16_suppl_2): S54 - S65.
[Abstract] [Full Text] [PDF]

Home page
 J Child NeurolHome page
P. D. Singhi, M. Ray, S. Singhi, and Narendra Kumar Khandelwal
Acute Disseminated Encephalomyelitis in North Indian Children: Clinical Profile and Follow-Up
J Child Neurol, October 1, 2006; 21(10): 851 - 857.
[Abstract] [PDF]

Home page
 J Child NeurolHome page
A. Ilias, E. Galanakis, M. Raissaki, and M. Kalmanti
Childhood Encephalitis in Crete, Greece
J Child Neurol, October 1, 2006; 21(10): 910 - 912.
[Abstract] [PDF]

Home page
 Arch NeurolHome page
T. Menge, B. Hemmer, S. Nessler, H. Wiendl, O. Neuhaus, H.-P. Hartung, B. C. Kieseier, and O. Stuve
Acute Disseminated Encephalomyelitis: An Update
Arch Neurol, November 1, 2005; 62(11): 1673 - 1680.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
E. Marchioni, S. Ravaglia, G. Piccolo, M. Furione, E. Zardini, D. Franciotta, E. Alfonsi, L. Minoli, A. Romani, A. Todeschini, et al.
Postinfectious inflammatory disorders: Subgroups based on prospective follow-up
Neurology, October 11, 2005; 65(7): 1057 - 1065.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
R C Dale and J A Branson
Acute disseminated encephalomyelitis or multiple sclerosis: can the initial presentation help in establishing a correct diagnosis?
Arch. Dis. Child., June 1, 2005; 90(6): 636 - 639.
[Abstract] [Full Text] [PDF]

Home page
 Am J Trop Med HygHome page
M. LADEMANN, P. GABELIN, M. LAFRENZ, C. WERNITZ, H. EHMKE, H. SCHMITZ, and E. C. REISINGER
ACUTE DISSEMINATED ENCEPHALOMYELITIS FOLLOWING PLASMODIUM FALCIPARUM MALARIA CAUSED BY VARICELLA ZOSTER VIRUS REACTIVATION
Am J Trop Med Hyg, April 1, 2005; 72(4): 478 - 480.
[Abstract] [Full Text] [PDF]

Home page
 J Child NeurolHome page
R. RamachandranNair, P. Manoj, M. Rafeequ, and A.S. Girija
Childhood Acute Disseminated Encephalomyelitis Presenting as Foix-Chavany-Marie Syndrome
J Child Neurol, February 1, 2005; 20(2): 163 - 165.
[Abstract] [PDF]

Home page
 NeurologyHome page
J. O. Susac, F. R. Murtagh, R. A. Egan, J. R. Berger, R. Bakshi, N. Lincoff, A. D. Gean, S. L. Galetta, R. J. Fox, F. E. Costello, et al.
MRI findings in Susac's syndrome
Neurology, December 23, 2003; 61(12): 1783 - 1787.
[Abstract] [Full Text] [PDF]