title: Long-term motor, cognitive and behavioral outcome of acute disseminated encephalomyelitis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the long-term motor and neurocognitive outcome of children with acute disseminated encephalomyelitis and to identify prognostic risk factors.
  
  
  METHODS
  The study included 43 children who were hospitalized due to acute disseminated encephalomyelitis during the years 2002-2012. The children underwent full neurological examinations, along with comprehensive neurocognitive and behavioral assessments.
  
  
  RESULTS
  Twenty-six (61%) children had different degrees of neurological sequelae after a mean follow-up of 5.5 ± 3.5 years. The most common residual impairment included attention-deficit hyperactivity disorder (44%), behavioral problems (32%), and learning disabilities (21%). Five (12%) children had a full-scale IQ of 70 or less, compared to 2.2% in the general population.
  
  
  CONCLUSIONS
  Neurocognitive sequelae were found even in children who were considered as fully recovered at the time of discharge. Risk factors for severe neurological sequelae were older age at diagnosis and male gender. We suggest neuropsychological testing and long-term follow-up for all children with acute disseminated encephalomyelitis, even in the absence of neurological deficits at discharge.
authors.affiliation: Department of Pediatrics A, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Smadar
authors.initials: S
authors.lastname: Shilo
authors.affiliation: Division of Hematology-Oncology, Schneider Medical Center, Petah Tikvah, Israel.
authors.forename: Orli
authors.initials: O
authors.lastname: Michaeli
authors.affiliation: Pediatric Neurology Unit, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Shahar
authors.affiliation: Pediatric Neurology Unit, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel. Electronic address: s_ravid@rambam.health.gov.il.
authors.forename: Sarit
authors.initials: S
authors.lastname: Ravid
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007360:Intelligence / Q000502:physiology*; D007859:Learning Disabilities / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D000066553:Problem Behavior; D012307:Risk Factors; D012737:Sex Factors
keywords: Acute disseminated encephalomyelitis; Children; Neurocognitive outcome