Neurological outcomes in patients with acute disseminated encephalomyelitis admitted in Imam Hussein pediatrics hospital, Isfahan, Iran, during the years 2011-2017

Abstract

Background: Acute disseminated encephalomyelitis (ADEM) is an inflammatory, demyelinating, multifocal disease primarily involves the white matter of the central nervous system. The most common symptoms are fever, headache, and nausea progressing to encephalopathy and coma. The purpose of this study was to evaluate neurological outcomes in pediatrics patients with acute disseminated encephalomyelitis. Methods: In this prospective study, we evaluated all pediatric patients with acute disseminated encephalomyelitis admitted in the service of pediatrics neurology in Imam Hussein pediatrics hospital, Isfahan, Iran, during the Years 2011-2017. The patients were diagnosed based on clinical and magnetic resonance imaging (MRI) findings. Findings: The most common symptoms included fever, headache, drowsiness, dizziness, and nausea. The most frequent findings in magnetic resonance imaging were T2 signal changes in basal ganglia, periventricular regions, and centrum semiovale and cerebellum. Of 21 patients enrolled in this study, 14 had full recovery, 1 had right hemiparesis, 1 had left hemiparesis with dysphagia, 1 suffered from delayed speech, cognition, and motor growth, 1 suffered from seizure, 1 had hemidystonia; 1 patient suffered from visual impairment and seizure, and 1 patient expired. Conclusion: In patients with encephalopathy, considering high level of suspicion of acute disseminated encephalomyelitis, and performing early imaging assessments will help initiate therapy and better prognosis. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved.