A Retrospective Assessment of the Acute Disseminated Encephalomyelitis in Children: An Observational Study
Authors/Creators
- 1. Senior Resident, Department of Paediatrics, ANMMCH, Gaya, Bihar, India
- 2. PG-Student, Department of Paediatrics, ANMMCH, Gaya, Bihar, India
Description
Abstract
Aim: The aim of the present study was to assess acute disseminated encephalomyelitis in children.
Material & Methods: A retrospectively evaluated 20 consecutive children with ADEM and adolescents at the
Department of Paediatrics for the duration of 12 months. All children had been diagnosed using reliable clinical,
laboratory, and neuroimaging techniques according to the International Pediatric Multiple Sclerosis (MS) Study
Group criteria.
Results: There were 20 children admitted with the diagnosis of ADEM during the study period. They included
16 (80%) girls and 4 (20%) boys. 4 children were below the age of three years, 8 children in the 3-6 year age
group and 8 children in the 6-12 year age group. The youngest was a six-month-old infant. All of them had first
episode of the illness. The common presenting symptoms were fever, vomiting, headache, gait disturbance and
generalized seizures. Neurological manifestations included altered sensorium, multiple cranial nerve involvement,
quadriplegia and paraplegia, dystonia and choreiform movements, nystagmus, bladder involvement (both
incontinence and retention), speech defect and double vision. Facial nerve was the most common cranial nerve
involved. Both LMN and UMN facial palsy occurred. Psychological manifestations included aggressive behavior,
emotional liability, and irritable, elated or depressed mood. Magnetic resonance imaging (MRI) was done in all
children. The area involved in the majority of children was the parietal lobe. Lesions were noted in the subcortical
white matter, mid brain, pons, corpus callosum, basal ganglia, medulla and cerebellum. One third of children had
spinal cord involvement.
Conclusion: Despite the serious neuropsychiatric manifestations, ADEM in children generally has a good
outcome. Children with ADEM need long-term follow up for cognitive impairments and emotional problems.
Clinical presentation of ADEM in the present sample is comparable to previous studies except for the female
preponderance. Further studies are required to analyze the reason for this female preponderance
Abstract (English)
Abstract
Aim: The aim of the present study was to assess acute disseminated encephalomyelitis in children.
Material & Methods: A retrospectively evaluated 20 consecutive children with ADEM and adolescents at the
Department of Paediatrics for the duration of 12 months. All children had been diagnosed using reliable clinical,
laboratory, and neuroimaging techniques according to the International Pediatric Multiple Sclerosis (MS) Study
Group criteria.
Results: There were 20 children admitted with the diagnosis of ADEM during the study period. They included
16 (80%) girls and 4 (20%) boys. 4 children were below the age of three years, 8 children in the 3-6 year age
group and 8 children in the 6-12 year age group. The youngest was a six-month-old infant. All of them had first
episode of the illness. The common presenting symptoms were fever, vomiting, headache, gait disturbance and
generalized seizures. Neurological manifestations included altered sensorium, multiple cranial nerve involvement,
quadriplegia and paraplegia, dystonia and choreiform movements, nystagmus, bladder involvement (both
incontinence and retention), speech defect and double vision. Facial nerve was the most common cranial nerve
involved. Both LMN and UMN facial palsy occurred. Psychological manifestations included aggressive behavior,
emotional liability, and irritable, elated or depressed mood. Magnetic resonance imaging (MRI) was done in all
children. The area involved in the majority of children was the parietal lobe. Lesions were noted in the subcortical
white matter, mid brain, pons, corpus callosum, basal ganglia, medulla and cerebellum. One third of children had
spinal cord involvement.
Conclusion: Despite the serious neuropsychiatric manifestations, ADEM in children generally has a good
outcome. Children with ADEM need long-term follow up for cognitive impairments and emotional problems.
Clinical presentation of ADEM in the present sample is comparable to previous studies except for the female
preponderance. Further studies are required to analyze the reason for this female preponderance
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Additional details
Dates
- Accepted
-
2023-09-20