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

Leake, John A. D.; Albani, Salvatore; Kao, Annie S.; Senac, Melvin O.; Billman, Glenn F.; Nespeca, Mark; Paulino, Amy; Quintela, Eileen R; Sawyer, Mark H.; Bradley, John S.

doi:10.1097/01.inf.0000133048.75452.dd

Cited by 357 publications

(341 citation statements)

References 70 publications

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“…While the majority of ADEM patients experience a monophasic disease course with partial or complete recovery, some have a recurrence of the same symptoms and lesion location more than 3 months following the initial event (recurrent ADEM) or experience new lesions and symptoms (multiphasic ADEM) (Krupp et al, 2007). A minority of individuals with ADEM can later develop MS, although the reported frequency of this occurrence is highly variable (0-28%) (Dale et al, 2000;Leake et al, 2004;Mikaeloff et al, 2004Mikaeloff et al, , 2007Tenembaum et al, 2002), requires many years of follow-up, and is dependent on the criteria used to define MS. For instance, Poser's criteria (Poser et al, 1983) would consider multiphasic ADEM as MS, as both are a recurring demyelinating events separated in space and time. The overlapping symptoms and lack of specific biomarkers can cause difficulties in distinguishing between MS and ADEM, especially in pediatric populations (Belman et al, 2007;Krupp et al, 2007;Wingerchuk, 2003).…”

Section: Ms and Related Inflammatory Demyelinating Cns Diseasesmentioning

confidence: 99%

Chapter 4 B Cells and Autoantibodies in the Pathogenesis of Multiple Sclerosis and Related Inflammatory Demyelinating Diseases

McLaughlin

Wucherpfennig

2008

Advances in Immunology

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Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). The mainstream view is that MS is caused by an autoimmune attack of the CNS myelin by myelin-specific CD4 T cells, and this perspective is supported by extensive work in the experimental autoimmune encephalomyelitis (EAE) model of MS as well as immunological and genetic studies in humans. However, it is important to keep in mind that other cell populations of the immune system are also essential in the complex series of events leading to MS, as exemplified by the profound clinical efficacy of B cell depletion with Rituximab. This review discusses the mechanisms by which B cells contribute to the pathogenesis of MS and dissects their role as antigen-presenting cells (APCs) to T cells with matching antigen specificity, the production of proinflammatory cytokines and chemokines, as well as the secretion of autoantibodies that target structures on the myelin sheath and the axon. Mechanistic dissection of the interplay between T cells and B cells in MS may permit the development of B cell based therapies that do not require depletion of this important cell population.

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Section: Ms and Related Inflammatory Demyelinating Cns Diseasesmentioning

confidence: 99%

Chapter 4 B Cells and Autoantibodies in the Pathogenesis of Multiple Sclerosis and Related Inflammatory Demyelinating Diseases

McLaughlin

Wucherpfennig

2008

Advances in Immunology

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“…ADEM is most common in children, with an incidence of approximately 4 per million of the population who are <20 years of age (and even higher among younger children) [53]. Adults can develop ADEM, but it is uncommon.…”

Section: Ademmentioning

confidence: 99%

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Geldern¹,

McPharlin

Becker

2012

Neurotherapeutics

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This chapter will review the spectrum of immunemediated diseases that affect the nervous system and may result in an admission to the neurological intensive care unit. Immunomodulatory strategies to treat acute exacerbations of neurological diseases caused by aberrant immune responses are discussed, but strategies for long-term immunosuppression are not presented. The recommendations for therapeutic intervention are based on a synthesis of the literature, and include recommendations by the Cochrane Collaborative, the American Academy of Neurology, and other key organizations. References from recent publications are provided for the disorders and therapies in which randomized clinical trials and large evidenced-based reviews do not exist. The chapter concludes with a brief review of the mechanisms of action, dosing, and side effects of commonly used immunosuppressive strategies in the neurocritical care unit.

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“…Patolojik olarak perivasküler enflamasyon, ödem ve demiyelinizasyonla belirgindir. Klinik olarak, hastal›¤a özgül olmayan sistemik belirti ve bulgularla s›n›rl› kalabilir ya da h›zl› geliflen fokal ya da mültifokal nörolojik ifllev bozuklu¤u görülebilir (3). Tan›, en iyi manyetik rezonans görüntüleme (MRG) ile yap›-l›r (4).…”

Section: Giriflunclassified

Transvers miyelit tablosu ile getirilen akut dissemine ansefalomiyelit olgusu

Kaya¹,

Özkan²,

Bektaş³

et al. 2010

tpa

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T Tr ra an ns sv ve er rs s m mi iy ye el li it t t ta ab bl lo os su u i il le e g ge et ti ir ri il le en n a ak ku ut t d di is ss se em mi in ne e a an ns se ef fa al lo om mi iy ye el li it t o ol lg gu us su u A A c ca as se e o of f a ac cu ut te e d di is ss se em mi in na at te ed d e en nc ce ep ph ha al lo om my ye el li it ti is s p pr re es se en nt te ed d w wi it th h t tr ra an ns sv ve er rs s m my ye el li it ti is s A Av vn ni i K Ka ay ya a, , M Mu us st ta af fa a Ö Öz zk ka an n, , M M. . S Se el lç çu uk k B Be ek kt ta afl fl, , M Me eh hm me et t A Aç ç› ›k kg gö öz z, , H Ha ay yr re et tt ti in n T Te em me el l, , E Er rt ta an n S Sa al l, , H Hü üs se ey yi in n Ç Ça ak ks se en n* * O Ol lg gu u S Su un nu um mu u C Ca as se e R Re ep po or rt t Ö Öz ze et t Akut dissemine ansefalomiyelit, merkezi sinir sisteminin enflamatuvar, demiyelinizan bir hastal›¤›d›r. Dokuz yafl›nda erkek hasta iki gün ön-ce bafllayan yürüyememe, bacaklar›n› hissedememe, idrar ve d›flk› kaç›rma yak›nmas› ile getirildi. Fizik bak›s›nda, üst ekstremitelerde kas gücü 5/5, alt ekstemitelerde 1/5 idi. Her iki alt ekstremitelerden bafllay›p T8 düzeyine kadar uzanan yüzeyel duyu kayb› vard›. Spinal manyetik rezonans görüntülemesinde, C3'ten konus medüllarise uzanan ve kontrast madde tutulumu gösteren hiperintens yayg›n lezyon saptand›. Elektromiyografi poliradikülonevritle, beyin manyetik rezonans görüntülemesi bulgular› akut dissemine ansefalomiyelit ile uyumluydu. Bu olgu dolay›s›yla transvers miyelit tablosu ile getirilen hastalarda akut dissemine ansefalomiyelit olabilece¤ini, bu nedenle spinal manyetik rezonans görüntülemesi yan›nda kraniyal manyetik rezonans görüntülemesinin de yap›lmas›n›n uygun olaca¤›n› vurgulamak isteriz. S Su um mm ma ar ry yAcute disseminated encephalomyelitis is an inflammatory and demyelinating disorder of central nervous system. A 9-year-old male was admitted with unable to walk, non-sensation of legs, urinary incontinence and encopresis for 2 days. On physical examination, muscle strength was 5/5 on upper extremities and 1/5 on lower extremities. Loss of pain, temperature and touch sensation was present on both lower extremities, reaches to T8 level. On spinal magnetic resonance imaging, diffuse hyperintensity from C3 to conus medullaris was detected. While electromyography was consistent with polyradiculoneuritis, magnetic resonance imaging findings were concordant with acute disseminated encephalomyelitis. On account of this case, we would like to emphasize that acute disseminated encephalomyelitis should be considered in patients presented with transverse myelitis; therefore, in addition to spinal magnetic resonance imaging, cranial magnetic resonance imaging should be examined in these patients. (Turk Arch Ped 2010; 45: 299-302) Key words: Acute disseminated encephalomyelitis, child, transverse myelitis 2 29 99 9 GiriflAkut dissemine ansefalomyelit (ADEM), merkezi sinir sisteminin ani bafllang›çl›, de¤iflken klinik seyir gösteren demiyelinizasyonla giden bir hastal›¤›d›r (1). ...

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

Cited by 357 publications

References 70 publications

Chapter 4 B Cells and Autoantibodies in the Pathogenesis of Multiple Sclerosis and Related Inflammatory Demyelinating Diseases

Chapter 4 B Cells and Autoantibodies in the Pathogenesis of Multiple Sclerosis and Related Inflammatory Demyelinating Diseases

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Transvers miyelit tablosu ile getirilen akut dissemine ansefalomiyelit olgusu

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