title: [Clinico-radiological profile of acute disseminated encephalomyelitis in the childhood population. A retrospective analysis of a series of 20 patients in a tertiary hospital].
abstract: BACKGROUND
  Acute disseminated encephalomyelitis (ADE) is an inflammatory disorder of the central nervous system that is mediated immunologically and of unknown pathogenesis. It can present at any age, but is much more frequent in children. ADE has no specific biological marker and diagnosis is based on findings from clinical and neuroimaging studies.
  
  
  OBJECTIVE
  To enhance our knowledge of the clinico-radiological profile of this disease.
  
  
  METHODS
  This retrospective study involved patients under 14 years of age who were admitted to a tertiary hospital over the last 15 years with a diagnosis of ADE. History, clinical presenting symptoms, lab findings from blood/cerebrospinal fluid analyses and radiological semiology were reviewed. In 16 cases an average follow-up of 25 months was performed.
  
  
  RESULTS
  The study examined 20 patients, 70% children, with a mean age of 4.4 years. Forty per cent had a previous febrile episode. Eighty-five per cent presented fever or vomiting, and 70% had altered states of mind. Motor deficits (45%), convulsions (35%) and involvement of the cranial nerves (30%) were predominant. Three children progressed with relapses and three others were left with motor sequelae. Magnetic resonance imaging showed hyperintense lesions in T2, with a pattern of scarce/no enhancement, which were predominantly located in the thalamus (70%), the spinal cord (67%) and the white matter of the sub-cortex (50%). Haemorrhagic ADE was diagnosed in two patients.
  
  
  CONCLUSIONS
  ADE is a condition with an important degree of general involvement and neurological repercussions, as well as considerable potential to leave the patient with sequelae. Clinico-analytical data and magnetic resonance scans of the head and spinal cord are relevant for the initial diagnosis and follow-up of patients with ADE.
authors.affiliation: Hospital Universitario La Fe, Valencia, Espana.
authors.forename: Miguel
authors.initials: M
authors.lastname: Tomás-Vila
authors.forename: Francisco
authors.initials: F
authors.lastname: Menor
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Otero-Reigada
authors.forename: Amparo
authors.initials: A
authors.lastname: Pérez-Tamarit
authors.forename: Montserrat
authors.initials: M
authors.lastname: Téllez de Meneses
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Pitarch-Castellanos
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003244:Consciousness Disorders / Q000209:etiology; D003389:Cranial Nerve Diseases / Q000209:etiology; D003937:Diagnosis, Differential; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008587:Meningitis, Viral / Q000175:diagnosis; D010956:Plasmapheresis; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D013030:Spain / Q000453:epidemiology; D063189:Symptom Assessment; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D000305:Adrenal Cortex Hormones; D002556:Cerebrospinal Fluid Proteins; D016756:Immunoglobulins, Intravenous; D000212:Acyclovir