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Acute Disseminated Encephalomyelitis: Clinical Series

Year 2005, Volume: 10 Issue: 3, 127 - 131, 01.06.2005

Abstract

Objectives: Acute disseminated encephalomyelitis is typically a monophasic, demyelinating disease of the central nervous system that predominantly affects children. The work was done to describe the epidemiologic, clinical, neuroimaging and laboratory features; treatmet and outcome in children with Acute disseminated encephalomyelitis. Materials and Methods: Ten children with acute disseminated encephalomyelitis were seen at the Firat University Pediatric Neurology Unit over a five year period (July 1999-June 2005). Diagnosis was based upon typical clinical features and characteristic findings on neuroimaging. Cerebrospinal fluid examination and other investigations were done, where appropriate, to rule out other causes of central nervous system disease. Results: Six children had a prodromal illness. The most common presenting symptoms were ataxia, dysarthria and seizures. All children had an abnormal neurological examination. In the first administration, only three patients had hyperintense signals on brain magnetic resonance imaging. All children were treated with methylprednisolone, one child with optic neuritis received both methylprednisolone and immunoglobulins Patients who had more than one relapse (n = 2) presented with new symptoms at each attack. Of 10 children, 80 % recovered completely, but the patients who had more than one relapse has severe disability (hemiparesis and optic atrophy). Conclusion: Although in the cases of acute disseminated encephalomyelitis complete clinical recovery is common, serious neurological complications are also seen in childhood The timing and duration of steroid treatment affects outcome. ©2005, Fırat Üniversitesi, Tıp Fakültesi

References

  • Rosman NP, Gottlieb SM, Bernstein CA. Acute hemorrhagic leukoencephalitis: recovery and reversal of magnetic resonance imaging findings in a child. J Child Neurol 1997;12:448-454.
  • Honkaniemi J, Dastidar P, Kahara V, Haapasalo H. Delayed MR imaging changes in acute disseminated encephalomyelitis. AJNR Am J Neuroradiol 2001; 22: 1117-1124.
  • Tselis AC, Lisak RP. Acute disseminated encephalomyelitis and isolated central nervous system demyelinative syndromes. Curr Opin Neurol 1995; 8: 227-229.
  • Murthy JM, Yangala R, Meena AK, Reddy JJ. Clinical, electrophysiological and magnetic resonance imaging study of acute disseminated encephalomyelitis. J Assoc Physicians India 1999; 47: 280-283.
  • Murthy JM. Acute disseminated encephalomyelitis. Neurol India 2002; 50: 238-243.
  • Wang PN, Fuh JL, Liu HC, Wang SJ. Acute disseminated encephalomyelitis in middle-aged or elderly patients. Eur Neurol 1996; 36: 219-223
  • Sriram S, Steinman L. Postinfectious and postvaccinial encephalomyelitis. Neurol Clin 1984; 2: 341-353.
  • Stuve O, Zamvil SS. Pathogenesis, diagnosis, and treatment of acute disseminated encephalomyelitis. Curr Opin Neurol 1999; 12: 395-401.
  • Garg RK. Acute disseminated encephalomyelitis. Postgrad Med J 2003; 79: 11-17.
  • Dale RC. Acute disseminated encephalomyelitis. Semin Pediatr Infect Dis 2003; 14: 90-95.
  • Hynson JL, Kornberg AJ, Coleman LT, et al. Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children. Neurology 2001; 56: 1308-1312.
  • Murthy SN, Faden HS, Cohen ME, Bakshi R. Acute Disseminated Encephalomyelitis . Pediatrics 2002; 1-7.
  • Hung KL, Liao HT, Tsai ML. Postinfectious encephalomyelitis: etiologic and diagnostic trends. J Child Neurol 2000; 15: 666670.
  • Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: a long-term follow-up study of 84 pediatric patients. Neurology 2002; 59: 1224-1231.
  • Baum PA, Barkovich AJ, Koch TK, Berg BO. Deep gray matter involvement in children with acute disseminated encephalomyelitis. AJNR Am J Neuroradiol 1994; 15: 1275-1283.
  • Davis SM, Murray NM, Diengdoh JV, Galea-Debono A, Kocen RS. Stimulus-sensitive spinal myoclonus. J Neurol Neurosurg Psychiatry 1981; 44: 884-888.
  • Singh S, Alexander M, Korah IP. Acute disseminated encephalomyelitis: MR imaging features. AJR Am J Roentgenol 1999; 173: 1101-1107.
  • Anlar B, Basaran C, Kose G, et al. Acute disseminated encephalomyelitis in children: outcome and prognosis. Neuropediatrics 2003; 34: 194-199.

Akut Dissemine Ensefalomyelit: Klinik Seri

Year 2005, Volume: 10 Issue: 3, 127 - 131, 01.06.2005

Abstract

Amaç: Akut dissemine ensefalomyelit tipik olarak eş zamanlı, genellikle çocukları etkileyen santral sinir sisteminin demiyelinizan bir hastalığıdır. Çalışmada akut dissemine ensefalomyelitli çocukların epidemolojik, klinik, kranyal görüntüleme ve laboratuar özellikleri; tedavi ve sonuçlarının araştırılması amaçlandı. Gereç ve Yöntem: Fırat Üniversitesi Pediatrik nöroloji ünitesinde beş yıllık bir süre içinde akut dissemine ensefalomyelitli 10 çocuk izlendi (Ocak 1999-Mayıs 2005). Tanı, tipik klinik özelliklere ve kranyal görüntülemelerinde bulunan karakteristik bulgulara dayanmaktaydı. Merkezi sinir sistemi hastalığının diğer nedenlerini dışlamak için beyin omurilik sıvısı incelemeleri ve diğer tetkikler yapıldı. Bulgular: Altı çocukda prodromal hastalık vardı. En yaygın görülen semptomlar ataksi, konuşma bozukluğu ve nöbet idi. Tüm çocuklarda anormal nörolojik muayene bulguları vardı. İlk incelemede, beyin manyetik rezonans görüntülemede yalnızca üç çocuk hiperintens sinyallere sahipti. Tüm çocuklar metil prednizolon ile tedavi edildi, optik nöritli bir çocukda hem metil prednizolon hemde intravenöz immunglobulin uygulandı. Birden fazla atak geçiren hastalarda (n=2) her atakta yeni semptomlar görüldü. On çocuğun %80'i tamamen iyileşmesine karşın, birden fazla tekrarlayan hastalarda ciddi sekel vardı (hemiparezi ve optik atrofi). Sonuç: Akut dissemine ensefalomyelitli olgularda tam klinik iyileşme yaygın olmasına rağmen, çocukluklarda ciddi nörolojik kompikasyonlar da görülebilir. Steroid tedavisinin zamanlama ve süresi sonucu etkiler. ©2005, Fırat Üniversitesi, Tıp Fakültesi

References

  • Rosman NP, Gottlieb SM, Bernstein CA. Acute hemorrhagic leukoencephalitis: recovery and reversal of magnetic resonance imaging findings in a child. J Child Neurol 1997;12:448-454.
  • Honkaniemi J, Dastidar P, Kahara V, Haapasalo H. Delayed MR imaging changes in acute disseminated encephalomyelitis. AJNR Am J Neuroradiol 2001; 22: 1117-1124.
  • Tselis AC, Lisak RP. Acute disseminated encephalomyelitis and isolated central nervous system demyelinative syndromes. Curr Opin Neurol 1995; 8: 227-229.
  • Murthy JM, Yangala R, Meena AK, Reddy JJ. Clinical, electrophysiological and magnetic resonance imaging study of acute disseminated encephalomyelitis. J Assoc Physicians India 1999; 47: 280-283.
  • Murthy JM. Acute disseminated encephalomyelitis. Neurol India 2002; 50: 238-243.
  • Wang PN, Fuh JL, Liu HC, Wang SJ. Acute disseminated encephalomyelitis in middle-aged or elderly patients. Eur Neurol 1996; 36: 219-223
  • Sriram S, Steinman L. Postinfectious and postvaccinial encephalomyelitis. Neurol Clin 1984; 2: 341-353.
  • Stuve O, Zamvil SS. Pathogenesis, diagnosis, and treatment of acute disseminated encephalomyelitis. Curr Opin Neurol 1999; 12: 395-401.
  • Garg RK. Acute disseminated encephalomyelitis. Postgrad Med J 2003; 79: 11-17.
  • Dale RC. Acute disseminated encephalomyelitis. Semin Pediatr Infect Dis 2003; 14: 90-95.
  • Hynson JL, Kornberg AJ, Coleman LT, et al. Clinical and neuroradiologic features of acute disseminated encephalomyelitis in children. Neurology 2001; 56: 1308-1312.
  • Murthy SN, Faden HS, Cohen ME, Bakshi R. Acute Disseminated Encephalomyelitis . Pediatrics 2002; 1-7.
  • Hung KL, Liao HT, Tsai ML. Postinfectious encephalomyelitis: etiologic and diagnostic trends. J Child Neurol 2000; 15: 666670.
  • Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: a long-term follow-up study of 84 pediatric patients. Neurology 2002; 59: 1224-1231.
  • Baum PA, Barkovich AJ, Koch TK, Berg BO. Deep gray matter involvement in children with acute disseminated encephalomyelitis. AJNR Am J Neuroradiol 1994; 15: 1275-1283.
  • Davis SM, Murray NM, Diengdoh JV, Galea-Debono A, Kocen RS. Stimulus-sensitive spinal myoclonus. J Neurol Neurosurg Psychiatry 1981; 44: 884-888.
  • Singh S, Alexander M, Korah IP. Acute disseminated encephalomyelitis: MR imaging features. AJR Am J Roentgenol 1999; 173: 1101-1107.
  • Anlar B, Basaran C, Kose G, et al. Acute disseminated encephalomyelitis in children: outcome and prognosis. Neuropediatrics 2003; 34: 194-199.
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Nimet Kabaku This is me

Ayşegül Neşe Çitak Kurt This is me

Publication Date June 1, 2005
Published in Issue Year 2005 Volume: 10 Issue: 3

Cite

APA Kabaku, N., & Kurt, A. N. Ç. (2005). Akut Dissemine Ensefalomyelit: Klinik Seri. Fırat Tıp Dergisi, 10(3), 127-131.
AMA Kabaku N, Kurt ANÇ. Akut Dissemine Ensefalomyelit: Klinik Seri. Fırat Tıp Dergisi. June 2005;10(3):127-131.
Chicago Kabaku, Nimet, and Ayşegül Neşe Çitak Kurt. “Akut Dissemine Ensefalomyelit: Klinik Seri”. Fırat Tıp Dergisi 10, no. 3 (June 2005): 127-31.
EndNote Kabaku N, Kurt ANÇ (June 1, 2005) Akut Dissemine Ensefalomyelit: Klinik Seri. Fırat Tıp Dergisi 10 3 127–131.
IEEE N. Kabaku and A. N. Ç. Kurt, “Akut Dissemine Ensefalomyelit: Klinik Seri”, Fırat Tıp Dergisi, vol. 10, no. 3, pp. 127–131, 2005.
ISNAD Kabaku, Nimet - Kurt, Ayşegül Neşe Çitak. “Akut Dissemine Ensefalomyelit: Klinik Seri”. Fırat Tıp Dergisi 10/3 (June 2005), 127-131.
JAMA Kabaku N, Kurt ANÇ. Akut Dissemine Ensefalomyelit: Klinik Seri. Fırat Tıp Dergisi. 2005;10:127–131.
MLA Kabaku, Nimet and Ayşegül Neşe Çitak Kurt. “Akut Dissemine Ensefalomyelit: Klinik Seri”. Fırat Tıp Dergisi, vol. 10, no. 3, 2005, pp. 127-31.
Vancouver Kabaku N, Kurt ANÇ. Akut Dissemine Ensefalomyelit: Klinik Seri. Fırat Tıp Dergisi. 2005;10(3):127-31.