title: Acute demyelinating encephalomyelitis: Clinical characteristics and outcome.
abstract: BACKGROUND
  ADEM, although relatively uncommon, is probably under-recognized.
  
  
  OBJECTIVE
  To spotlight the clinical profile and therapeutic outcome of children with ADEM.
  
  
  METHODS
  This is a prospective study of patients with ADEM who were admitted to the Pediatric Departments in Aladan and Alfarawanya Hospitals in Kuwait, from January 2009 to January 2011. Clinical, microbiological and radiological data were analyzed.
  
  
  RESULTS
  Of 48 patients presented with acute neurological symptoms and signs, 21 patients fulfilled criteria for ADEM. 80.95% of cases were presenting in winter and spring, 57% of patients had a history of upper respiratory tract illness. The commonest presentations were motor deficits, convulsions and altered consciousness. CSF virology studies showed herpes simplex virus (HSV) and Epstein-Barr virus (EBV) (3 patients) whereas nasal and nasopharyngeal swab showed evidence of influenza H1N1 virus (1 patient). Brain MRI was performed in all patients and revealed multiple hyperintense supratentorial brain lesions on T2/FLAIR images. 85.7% of patients had cortical and/or subcortical white matter lesions which were bilateral and asymmetric in location and size.
  
  
  CONCLUSIONS
  ADEM although rare must be considered in children with acute onset of neurological signs and symptoms and must be distinguished from any acute neurological insult.
authors.affiliation: Faculty of Medicine, Elmansoura University, Egypt.
authors.forename: Ahmed Farag
authors.initials: AF
authors.lastname: Elhassanien
authors.forename: Hesham Abdel
authors.initials: HA
authors.lastname: Aziz
keywords: Acute disseminated encephalomyelitis; immunosuppressive therapy; multifocal demyelination