Acute Disseminated Encephalomyelitis in Childhood; Epidemiologic, Clinical, and Laboratory Features

Background: acute disseminated encephalomyelitis (adem),which occurs spontaneously or after systemic viral infectionand vaccination mostly affects children. this study aims at describingthe epidemiologic, clinical, neuroimaging, laboratoryfeatures, treatment and outcome in children who diagnosed ashaving adem and admitted in a referral center in tehran.methods: this descriptive prospective study was conducted onpatients with a diagnosis of adem over a period of 30 months,between sep 2003 and mar 2006, admitted to the neurologyward of mofid pediatric hospital. all these patients were visitedin regular follow-up every 6 months for two years.results: eighteen patients with the mean age of 6 years (range5 months - 12 years) were studied. no sex predominance wasnoted. sixty-one percent had prodromal illness, and two patientshad been vaccinated before the illness. thirteen (72%)patients presented in fall or winter. motor deficits and cranialnerve palsy were the most common features, which had occurredin 13 (72%) patients. abnormal findings in cerebrospinalfluid evaluation were detected in 33% of the patients.brain computed tomography was normal in all but one patient.electroencephalograms done in nine patients were normal in54%. magnetic resonance imaging showed lesions were mostcommonly in the subcortical and periventricular areas (76%).nine (50%) patients were treated with corticosteroids and intravenousimmunoglobulin. the mortality rate was 5.5%, andthe relapse occurred only in one case. in two-thirds of the patients,prognosis for complete recovery was excellent.conclusion: childhood adem is a benign condition, affectingboth sexes equally. recurrent infections have been itscommon cause in our center.