title: Acute disseminated encephalomyelitis in children and adolescents: a single center experience.
abstract: BACKGROUND
  Acute disseminated encephalomyelitis is an immune-mediated disease that produces multiple inflammatory lesions in the brain and spinal cord.
  
  
  METHODS
  This study retrospectively evaluated 15 children with acute disseminated encephalomyelitis in children and adolescents from a single institution in Adana, Turkey.
  
  
  RESULTS
  The patients presented in a seasonal distribution, with 73.3%: (11/15) presenting in winter or spring. The majority of patients (13/15, 86.7%) had a history of acute febrile illness 2 to 40 days before presentation, and five children had serologic evidence of specific triggers: mycoplasma (2 children), influenza-A (H1N1) (1 child), or Epstein-Barr virus. All children were treated with a standard protocol of 3 to 5 days of intravenous administration of methylprednisolone and intravenous immunoglobulin for patients who continued to deteriorate. Oseltamivir and clarithromycin were administered in patients with influenza-A (H1N1) and mycoplasma according to the serology. In 13 patients, all neurologic signs and symptoms resolved after treatment. Only one patient was left with severe neurologic sequelae and another child had recurrent attacks and was ultimately diagnosed with possible multiple sclerosis.
  
  
  CONCLUSIONS
  The present series demonstrates that acute disseminated encephalomyelitis in children occurs predominantly in winter or spring and often follows an upper respiratory tract illness for those along the southern coast of Anatolia (Mediterranean region). Early treatment with immunomodulative agents is recommended and is likely to result in a favorable outcome or full recovery. This study also suggests benefit from antiviral and antibiotic treatment initiated as soon as possible after the onset of illness.
authors.affiliation: Department of Pediatrics, Neurology Division, Adana Teaching and Medical Research Center, Adana, Turkey. Electronic address: ilknur_erol@yahoo.com.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Erol
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Ozkale
authors.forename: Ozlem
authors.initials: O
authors.lastname: Alkan
authors.forename: Fusun
authors.initials: F
authors.lastname: Alehan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology
chemical_list: D016756:Immunoglobulins, Intravenous; D008775:Methylprednisolone
keywords: Alzheimer's disease; Turkey; acute disseminated encephalomyelitis; adolescents; children; multiple sclerosis