title: Clinical study of childhood acute disseminated encephalomyelitis, multiple sclerosis, and acute transverse myelitis in Fukuoka Prefecture, Japan.
abstract: Acute disseminated encephalomyelitis (ADEM) has recently been studied in several countries owing to the development and wide spread use of imaging technology, but few epidemiological studies of childhood ADEM have been undertaken in Asian countries. To perform a comprehensive survey of ADEM and related diseases in Japanese children, we conducted a multicenter, population-based study on childhood ADEM, multiple sclerosis, and acute isolated transverse myelitis in Fukuoka Prefecture, Japan. We identified 26 children with ADEM, 8 with multiple sclerosis, and 4 with acute transverse myelitis during 5 years between September 1998 and August 2003. The incidence of childhood ADEM under the age of 15 years was 0.64 per 100,000 person-years, mean age at onset was 5.7 years, and male-female ratio was 2.3:1. The prevalence of childhood multiple sclerosis was 1.3 per 100,000 persons. The mean age at onset of multiple sclerosis, 9.3 years, was significantly higher than that of ADEM. Nineteen (73%) and four (15%) patients with ADEM experienced antecedent infectious illnesses and vaccinations, respectively, within 1 month before the onset. Clinical and radiological findings of ADEM revealed that the frequency of seizures, mean white blood cell counts in cerebrospinal fluid, and the frequency of subcortical lesions in Fukuoka study, seemed to be higher than those in previous non-Asian studies. These findings suggest that there are ethnic or geographical differences in the incidence and clinical features of ADEM, and that there might be potent genetic or environmental risk factors for ADEM distinct from those for multiple sclerosis.
authors: Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. htorys@pediatr.med.kyushu-u.ac.jp
authors: Hiroyuki
authors: H
authors: Torisu
authors: Ryutaro
authors: R
authors: Kira
authors: Yoshito
authors: Y
authors: Ishizaki
authors: Masafumi
authors: M
authors: Sanefuji
authors: Yui
authors: Y
authors: Yamaguchi
authors: Sawa
authors: S
authors: Yasumoto
authors: Yoshihiko
authors: Y
authors: Murakami
authors: Masayuki
authors: M
authors: Shimono
authors: Shinichiro
authors: S
authors: Nagamitsu
authors: Mayumi
authors: M
authors: Masuzaki
authors: Masano
authors: M
authors: Amamoto
authors: Rikako
authors: R
authors: Kondo
authors: Tomohiko
authors: T
authors: Uozumi
authors: Miyuki
authors: M
authors: Aibe
authors: Kenjiro
authors: K
authors: Gondo
authors: Toshio
authors: T
authors: Hanai
authors: Sinichi
authors: S
authors: Hirose
authors: Toyojiro
authors: T
authors: Matsuishi
authors: Akira
authors: A
authors: Shirahata
authors: Akihisa
authors: A
authors: Mitsudome
authors: Toshiro
authors: T
authors: Hara
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004673:Encephalomyelitis, Acute Disseminated / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D009188:Myelitis, Transverse / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015995:Prevalence; D012737:Sex Factors