Long-term prognosis of pediatric patients with relapsing acute disseminated encephalomyelitis.
Although long-term follow-up data are available for cases with acute disseminated encephalomyelitis, the findings range widely because of the lack of consistent definitions. Using the International Pediatric Multiple Sclerosis Study Group definitions strictly, we determined the long-term prognosis of children with acute disseminated encephalomyelitis, especially concerning relapsing cases. In our cohort of 86 children who presented with a first event of inflammatory demyelinating disease of central nervous system, 33 patients (38%) met the Study Group criteria for acute disseminated encephalomyelitis of which 9 patients had relapses. The mean follow-up duration was 12.8 years for relapsing cases and 9.2 years for all patients with acute disseminated encephalomyelitis. The risk of developing relapses is 27% but the risk of developing multiple sclerosis from acute disseminated encephalomyelitis is low at 6%. All relapsing cases had a benign course on prolonged follow-up, in spite of multiple relapses in the first 3 years.
Mar
Soe
S
Department of Pediatric and Developmental Neurology, Washington University School of Medicine, St Louis, Missouri 63110, USA. mars@neuro.wustl.edu
Lenox
Jason
J
Benzinger
Tammie
T
Brown
Stephanie
S
Noetzel
Michael
M
D000293:Adolescent; D001921:Brain / Q000473:pathology*; D002648:Child; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000175:diagnosis; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D018696:Neuroprotective Agents / Q000627:therapeutic use; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D018696:Neuroprotective Agents; D008775:Methylprednisolone