title: Acute disseminated encephalomyelitis: a long-term prospective study and meta-analysis.
abstract: BACKGROUND
  There are only a few series in the literature on acute disseminated encephalomyelitis (ADEM) in children.
  
  
  OBJECTIVE
  the aims of this study were to perform (i) a prospective clinical/imaging study (1992-2009) on ADEM in children consecutively referred to our institution in Catania, Italy, and (ii) to undertake a systematic review and meta-analysis of published ADEM pediatric cohorts (>10 cases).
  
  
  RESULTS
  We identified 17 patients with ADEM (incidence <10 years of age=1.1 per 100 000 person-years). 15 previously published cohorts were compared with our cohort: (i) systematically reviewed (750 cases); and (ii) meta-analyzed (492/750 cases). The 17 patients had the following characteristics: (a) male-to-female ratio, 1.4 (vs. 1.2-1.3 in previous cohorts); (b) mean age at presentation, 3.6 years (vs. 7.1 years in previous cohorts); (c) specific preceding triggering factor, 88% (vs. 69-79% in previous cohorts); (d) the most common initial signs were ataxia, seizures, headache, and thalamic syndrome; (e) brain imaging revealed >3 lesions in 100% (vs. 92% in previous cohorts); (f) the outcome was good in 94% (vs. 70-75% in previous cohorts); and (g) 12% relapsed once (vs. 18% in previous cohorts).
  
  
  CONCLUSIONS
  ADEM is generally a benign condition that mosly affects boys more than girls and rarely recurs.
authors: Department of Pediatrics, University Hospital Vittorio Emanuele, Catania, Italy.
authors: P
authors: P
authors: Pavone
authors: M
authors: M
authors: Pettoello-Mantovano
authors: A
authors: A
authors: Le Pira
authors: I
authors: I
authors: Giardino
authors: A
authors: A
authors: Pulvirenti
authors: R
authors: R
authors: Giugno
authors: E
authors: E
authors: Parano
authors: A
authors: A
authors: Polizzi
authors: A
authors: A
authors: Distefano
authors: A
authors: A
authors: Ferro
authors: L
authors: L
authors: Pavone
authors: M
authors: M
authors: Ruggieri
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D017668:Age of Onset; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D004569:Electroencephalography; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids