title: Clinical Profiles and Short-Term Outcomes of Acute Disseminated Encephalomyelitis in Adult Chinese Patients.
abstract: OBJECTIVE
  Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that predominantly affects children. Previous studies have mostly involved children in Western developed countries.
  
  
  METHODS
  This study retrospectively reviewed the clinical profiles of ADEM in adult Chinese patients.
  
  
  RESULTS
  ADEM occurred during summer and autumn in about two-thirds of the 42 included patients. Prior infection was found in five patients and no preimmunization was recorded. The most frequent clinical presentations were alterations in consciousness (79%) and behavior changes (69%), followed by motor deficits (64%) and fever (50%). About one-quarter (26%) of the patients showed positive results for oligoclonal bands, and about half of them exhibited increases in the IgG index and 24-hour IgG synthesis rate. Magnetic resonance imaging showed white- and gray-matter lesions in 83% and 23% of the patients, respectively. Steroids were the main treatment, and full recovery occurred in 62% of the patients, with residual focal neurological deficits recorded in a few patients. After a mean follow-up period of 3.4 years, two patients exhibited recurrence and one patient exhibited a multiphasic course. One patient was diagnosed with multiple sclerosis (MS).
  
  
  CONCLUSIONS
  With the exception of the seasonal distribution pattern and prior vaccine rate, the clinical profiles of ADEM in adult Chinese patients are similar to those in pediatric populations. No specific markers are available for distinguishing ADEM from MS at the initial presentation. Careful clinical evaluations, cerebrospinal fluid measurements, and neuroradiological examinations with long-term follow-up will aid the correct diagnosis of ADEM.
authors.affiliation: Department of Neurology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Hong Qi
authors.initials: HQ
authors.lastname: Yang
authors.affiliation: Department of Pharmacology, Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China.
authors.forename: Wen Cong
authors.initials: WC
authors.lastname: Zhao
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Wei Min
authors.initials: WM
authors.lastname: Yang
authors.affiliation: Department of Radiology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Yong Li
authors.initials: YL
authors.lastname: Li
authors.affiliation: Department of Neurology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Zhi Kun
authors.initials: ZK
authors.lastname: Sun
authors.affiliation: Department of Neurology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Neurology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou, China. liwei71@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Neurology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou, China. majj.1124@yahoo.com.cn.
authors.forename: Jian Jun
authors.initials: JJ
authors.lastname: Ma
keywords: acute disseminated encephalomyelitis; magnetic resonance imaging; multiple sclerosis; oligoclonal bands