Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of Iran
Background: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder. The pathogenesis is unclear, but it is thought to be immune-mediated. The prognosis is favorable, with most children making a full recovery. Objectives: The present report analyzed different clinica...
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| Format: | Article |
| Language: | English |
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Mazandaran University of Medical Sciences
2016-01-01
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| Series: | Journal of Pediatrics Review |
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| Online Access: | http://jpr.mazums.ac.ir/browse.php?a_code=A-10-30-46&slc_lang=en&sid=1 |
| _version_ | 1818133207845961728 |
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| author | Ali Nikkhah Mohammad Reza Salehiomran |
| author_facet | Ali Nikkhah Mohammad Reza Salehiomran |
| author_sort | Ali Nikkhah |
| collection | DOAJ |
| description | Background: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder. The pathogenesis is unclear, but it is thought to be immune-mediated. The prognosis is favorable, with most children making a full recovery.
Objectives: The present report analyzed different clinical presentations, response to treatment and outcome in a series of 11 patients with ADEM who referred to our tertiary center in north of Iran from 2010 to 2014.
Materials and Methods: In this retrospective simple descriptive review, eleven cases with ADEM admitted in the neurology ward from 2010 to 2014 were enrolled. The clinical findings and laboratory and imaging results of patients were reviewed. All of these cases were evaluated with neurological examination, serologic tests for bacterial meningitis and viral encephalitis (especially, herpes simplex virus) and brain MRI without contrast. After discharge, patients were followed for at least six months (6 to 12 months) clinically and radiologically.
Results: Of 11 children, 8 were male and 3 female. Their ages ranged between 4 and 10 years. The mean interval between the preceding infection and symptoms of encephalomyelitis was nine days. The most common presenting symptoms were ataxia in 45.4%, fever and headache in 36.4% and altered consciousness in 18.2% of patients. Neurological examination revealed pyramidal motor signs such as brisk deep tendon reflexes (hyperreflexia) (81.8%), cranial nerve involvement (18.2%), dysarthria (9.1%) and abnormal movements (9.1%). We followed up these patients in long-term for 6 to 12 months. Only in 1 child who received IVIG, mild ataxia had reminded.
Conclusions: The prognosis of acute disseminated encephalomyelitis (ADEM) is favorable. Early diagnosis and prompt treatment of ADEM would probably reduce morbidity. |
| first_indexed | 2024-12-11T08:49:04Z |
| format | Article |
| id | doaj.art-266dc5001fd04098b7d0ce6719ef30bf |
| institution | Directory Open Access Journal |
| issn | 2322-4398 2322-4401 |
| language | English |
| last_indexed | 2024-12-11T08:49:04Z |
| publishDate | 2016-01-01 |
| publisher | Mazandaran University of Medical Sciences |
| record_format | Article |
| series | Journal of Pediatrics Review |
| spelling | doaj.art-266dc5001fd04098b7d0ce6719ef30bf2022-12-22T01:14:04ZengMazandaran University of Medical SciencesJournal of Pediatrics Review2322-43982322-44012016-01-014100Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of IranAli Nikkhah0Mohammad Reza Salehiomran1 Non-Communicable Pediatric Diseases Research Center, Amirkola Children’s Hospital, Babol University of Medical Sciences, Babol, IR Iran Non-Communicable Pediatric Diseases Research Center, Amirkola Children’s Hospital, Babol University of Medical Sciences, Babol, IR Iran Background: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder. The pathogenesis is unclear, but it is thought to be immune-mediated. The prognosis is favorable, with most children making a full recovery. Objectives: The present report analyzed different clinical presentations, response to treatment and outcome in a series of 11 patients with ADEM who referred to our tertiary center in north of Iran from 2010 to 2014. Materials and Methods: In this retrospective simple descriptive review, eleven cases with ADEM admitted in the neurology ward from 2010 to 2014 were enrolled. The clinical findings and laboratory and imaging results of patients were reviewed. All of these cases were evaluated with neurological examination, serologic tests for bacterial meningitis and viral encephalitis (especially, herpes simplex virus) and brain MRI without contrast. After discharge, patients were followed for at least six months (6 to 12 months) clinically and radiologically. Results: Of 11 children, 8 were male and 3 female. Their ages ranged between 4 and 10 years. The mean interval between the preceding infection and symptoms of encephalomyelitis was nine days. The most common presenting symptoms were ataxia in 45.4%, fever and headache in 36.4% and altered consciousness in 18.2% of patients. Neurological examination revealed pyramidal motor signs such as brisk deep tendon reflexes (hyperreflexia) (81.8%), cranial nerve involvement (18.2%), dysarthria (9.1%) and abnormal movements (9.1%). We followed up these patients in long-term for 6 to 12 months. Only in 1 child who received IVIG, mild ataxia had reminded. Conclusions: The prognosis of acute disseminated encephalomyelitis (ADEM) is favorable. Early diagnosis and prompt treatment of ADEM would probably reduce morbidity.http://jpr.mazums.ac.ir/browse.php?a_code=A-10-30-46&slc_lang=en&sid=1Acute Disseminated EncephalomyelitisADEMChildrenOutcomeIranCase Series |
| spellingShingle | Ali Nikkhah Mohammad Reza Salehiomran Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of Iran Journal of Pediatrics Review Acute Disseminated Encephalomyelitis ADEM Children Outcome Iran Case Series |
| title | Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of Iran |
| title_full | Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of Iran |
| title_fullStr | Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of Iran |
| title_full_unstemmed | Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of Iran |
| title_short | Acute Disseminated Encephalomyelitis: A Review of Eleven Cases in Childhood in North of Iran |
| title_sort | acute disseminated encephalomyelitis a review of eleven cases in childhood in north of iran |
| topic | Acute Disseminated Encephalomyelitis ADEM Children Outcome Iran Case Series |
| url | http://jpr.mazums.ac.ir/browse.php?a_code=A-10-30-46&slc_lang=en&sid=1 |
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