[Acute disseminated encephalomyelitis in childhood].
OBJECTIVE
Acute disseminated encephalomyelitis is a rare inflammatory demyelinating disorder often preceded by infection or vaccination. The purpose of the study was the systematic analysis of clinical, radiological and microbiological profiles of children treated at Szent László Hospital, and the comparison of findings with literature data.


METHODS
Demographic, infectological, clinical, radiological, laboratory and virological data of patients treated and followed-up between 1-Jan-1998 and 30-June-2008 were reviewed and analysed.


RESULTS
19 children met diagnostic criteria. Their mean age was 6.8 years. A prodromal illness--mostly febrile viral infection, upper respiratory infection or chickenpox--preceded neurological symptoms in 17 patients. All had polysymptomatic encephalopathy, 2 children had spinal symptoms. The cerebrospinal fluid was abnormal in all but one. A viral etiology was definite in 7 and probable in 8 cases. MRI disclosed white matter changes in 18, cortical and deep gray matter in 16, cerebellar in 6, brain stem in 14 and spinal cord changes in 2 cases. Repeat MRI performed mean 4 months later showed complete resolution in 6 and partial resolution in 11 patients. 13 patients received high-dose methylprednisolone, 2 of whom were also treated with plasma exchange and 1 with immunoglobulin. 9 children required mechanical ventilation. 2 patients died, 10 recovered without and 7 with sequelae. 2 patients developed further demyelinating events: multiple sclerosis and multiphasic disseminated encephalomyelitis, respectively.


CONCLUSIONS
Clinical, radiological and follow-up results were similar to those published in literature however, triggering viruses were identified in a larger proportion of cases.
Liptai
Zoltán
Z
László Kórháza, Gyermekgyógyászati Osztály, 1097 Budapest, Gyáli út 5-7. zoltan.liptai@laszlokorhaz.hu
Ujhelyi
Eniko
E
Mihály
Ilona
I
Rudas
Gábor
G
Barsi
Péter
P
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000821:virology; D018792:Encephalitis, Viral / Q000175:diagnosis / Q000628:therapy; D004673:Encephalomyelitis, Acute Disseminated / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000628:therapy* / Q000821:virology; D004827:Epilepsy / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D008775:Methylprednisolone / Q000627:therapeutic use; D018696:Neuroprotective Agents; D010951:Plasma Exchange; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology; D014777:Virus Diseases / Q000150:complications
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D007136:Immunoglobulins; D018696:Neuroprotective Agents; D008775:Methylprednisolone