ICNC Abstracts, ICNC 2018

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Intravenous immunoglobulin versus methyl prednisolone in children with ADEM:: a randomized controlled trial
Rajniti Prasad, Gautam Goswami

Last modified: 2018-09-09


Introduction: Acute Disseminated Encephalomyelitis (ADEM) is an immune-mediated inflammatory and demyelinating disorder of the central nervous system, commonly preceded by an infection or vaccination. Conventional therapy is methylprednisolone and newer therapy is intravenous immunoglobulin (IVIg)

Objective: To assess efficacy of methylprednisolone and intravenous immunoglobulin on neurological recovery at 1week, 1 month and 3 months after completion of treatment in children with ADEM.

Methods: We performed a randomised control trial on 22 children(12 belonged to methyprednisolone group and 10; intravenous immunoglobulin group )with ADEM, which fulfilled imaging criteria, admitted in our hospital and assessed the neurological recovery by mRS scale at discharge, 1month and 3 months interval after completion of treatment with either of the drugs. We also assess neurological deficit, seizure and adverse reaction of the drugs in follow up. Collected data was analysed by SPSS version.20 software.

Results: Out of 22 children, 12 were male  and mostly belonged to 5-10 yrs. Upper respiratory tract infection was commonest preceding infection followed viral  exanthem and diarrhea. Early recovery was observed in patients received IVIg, but at three month follow up, recovery observed between both the groups were comparable. There were no statistically significant value (P value <0.05) regarding neurological recovery, follow up seizure or adverse reaction between both the groups.

Conclusion: There is no significant difference in outcome in children with ADEM treated with methylprednisolone or IVIg. Both are equally effective in first episode non fulminant ADEM.


ADEM, intravenous immunoglobulin, methylprednisolone

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