A Hospital-Based Assessment of the Acquired Demyelinating Diseases in Children: A Retrospective Study

Description

Abstract (English)

Abstract
Aim: The aim of the present study was to assess the acquired demyelinating diseases in children.
Methods: The present study was conducted in the Department of Paediatrics, IGIMS, Patna, Bihar, India from
December 2016 to November 2018. A total of 50 patients were enrolled in the study.
Results: Of these, 33 (66%) cases were of acquired demyelinating encephalomyelitis (ADEM), 10 (20%) of
transverse myelitis (TM), 5 (10%) of neuromyelitis optica (NMO), 1 (2%) of optic neuritis (ON) and 1 (2%) of
multiple sclerosis (MS). The mean age of presentation was 7.7 years (range: 2-12 years). Of 50 cases, 24 (48%)
were male and 26 (52%) females. History of preceding illness was present as upper respiratory infection /acute
febrile illness and mean duration between preceding events and onset of symptoms was 7.24±2.9 days. All patients
diagnosed with ADEM had encephalopathy. Areas involved in descending order of frequency were subcortical
white matter, basal ganglia, thalamus, brainstem, cerebellum and spinal cord involvement.
Conclusion: Children presenting with new, subacute focal neurological deficits with history of some preceding
event and in absence of trauma, metabolic derangements, or structural abnormalities should be suspected of having
acquired CNS demyelination. These patients should be investigated with CSF analysis, serum antibodies and
neuroimaging. ADEM is the most common among ADS. Early diagnosis and management with steroid therapy
improves outcome in most of the patients.