ICNC Abstracts, ICNC 2018

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Clinical and Neuroradiological profile of Acute Disseminated Encephalomyelitis in 13 children at tertiary center in Saudi Arabia
Amal Yousef Kentab, Amal Y. Kentab, Mustafa AM. Salih, Hamdy H. Hassan, Mohammed Na N. Al-Nasser, Heba Y. El khashab

Last modified: 2018-09-09

Abstract


Introduction:
Acute Disseminated Encephalitis (ADEM) is usually a monophasic polysymptomatic inflammatory condition of the central nervous system with an underling autoimmune pathology that principally involves the white matter although the grey matter may also be affected.
Methods
A 10 - year (2000-2010) retrospective chart review of children with the diagnosis of ADEM was conducted at King Khalid University Hospital.

Results:
Thirteen patients were identified.  The age of presentation range between (10 months -11.6 y) History of preceding Upper respiratory tract infection was noted in 69%. Polysymptomatic presentation was seen in all patients. The most often presenting signs were pyramidal signs in 92%, cranial nerve palsies in 84.6%, and altered sensorium in 53.8%.  Brain magnetic resonance imaging (MRI) identified white matter lesions in all patients. Deep grey matter involved in 23% and spinal cord lesions in 28.6%. Three patients achieved spontaneous clinical remission. Favorable outcome with steroids was observed in 10 patients. Out of those 3 received additional intravenous immunoglobulin. All patients survived except for one.  41.6% had excellent recovery, 41.6% had mild neurologic sequel with high functional and 16.6% had moderate to severe neurologic sequel.
Conclusion:

The epidemiologic data was consistent with the previous reported studies. MRI remains the imaging method of choice. Prognosis for survival and outcome was favorable with the use of corticosteroids and or IV immunoglobulin in all such cases.


Keywords


Acute disseminated encephalomyelitis, Multiple sclerosis, MRI, Children.

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