Acute disseminated encephalomyelitis: recognition in the hands of general paediatricians

Stonehouse, M; Gupte, Girish; Wassmer, Evangeline; Whitehouse, William P

doi:10.1136/adc.88.2.122

Cited by 82 publications

(92 citation statements)

References 23 publications

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“…Other landmark articles were those of Kesselring et al [29] on the distinctions between MS and DEM, and of van der Meyden et al [30] , who demonstrated gadolinium enhancement of almost all the lesions seen in DEM, an important point in differentiating it from MS in which usually only one or two plaques enhance. The lesion load is often much greater than what is seen in MS [31] . Indeed a number of authors have stressed the unique importance of MRI to differentiate between MS and DEM [32,33] .…”

Section: Recurrent Dem and Msmentioning

confidence: 88%

The Accuracy of Prevalence Rates of Multiple Sclerosis: A Critical Review

Poser

Brinar

2007

Neuroepidemiology

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Review of the recent medical literature raises doubts about the reliability of reported prevalence rates of multiple sclerosis (MS). Many published prevalence rates are inflated. Some studies have shown that relying on clinical information and MRI interpretation leads to one third of incorrect MS diagnoses. The most important error is failing to distinguish between the clinical and MRI characteristics of MS and of disseminated encephalomyelitis (DEM) in both their acute and relapsing forms. The diagnostic criteria in current usage, including those relating to imaging, do not differentiate between MS and other recurrent inflammatory demyelinating diseases of the central nervous system. Considering a second demyelinating episode following a clinically isolated symptom or acute DEM, as confirming MS, is another major source of error. Another is including cases with onset before they entered the study group or moved to the geographic area. Neuromyelitis optica (NMO) has long been considered an MS variant and in Far Eastern countries it is counted as the ‘oriental’ form of MS, falsely inflating prevalence rates of MS in those areas. Recent immunologic and radiologic evidence shows that at least some NMO cases represent instances of DEM.

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Section: Recurrent Dem and Msmentioning

confidence: 88%

The Accuracy of Prevalence Rates of Multiple Sclerosis: A Critical Review

Poser

Brinar

2007

Neuroepidemiology

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“…Depending on the pace of regression of the clinical features, treatment with oral prednisolone at a dose of 2 mg/kg/day can be started and a decreasing dose can be administrated for 4 to 6 weeks [16]. If the treatment is not adequate, plasmapheresis or intravenous immunoglobulines constitute an alternative treatment [17].…”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Disseminated Encephalomyelitis Mimicking Leukodystrophy

et al. 2010

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Summary: Acute disseminated encephalomyelitis (ADEM) is a monophasic, immune-mediated demyelinating disorder that can follow immunizations or more often infections including rubeola, rubella, varicella, herpes zoster, mumps, Mycoplasma pneumoniae, or, more commonly, other nonspecific upper respiratory tract infections. Documentation of a preceding illness is not required to make this diagnosis. This report examines the case of a 9-month-old male patient presenting with the features of an acute leukodystrophy following innoculation with the mixed vaccine Pentaxim (Sanofi Pasteur, Lyon-France) while suffering from a lower respiratory tract infection, and who was eventually diagnosed as ADEM. The case is presented as a reminder that ADEM can sometimes be linked to lower respiratory tract infection and vaccination, and that the features in such cases can be confused with leukodystrophy.

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“…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). Bu makalede, transvers miyelit tablosu ile getirilip ADEM tan›s› alan dokuz yafl›nda bir erkek olgu sunulmufltur.…”

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: recognition in the hands of general paediatricians

Cited by 82 publications

References 23 publications

The Accuracy of Prevalence Rates of Multiple Sclerosis: A Critical Review

The Accuracy of Prevalence Rates of Multiple Sclerosis: A Critical Review

A Case of Acute Disseminated Encephalomyelitis Mimicking Leukodystrophy

Transvers miyelit tablosu ile getirilen akut dissemine ansefalomiyelit olgusu

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