| Clinical characteristics and prognosis of acute disseminated encephalomyelitis based on the lesions on MRI |
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Sunghoon Chung, Sungsin Park, Sajun Chung |
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Department of Pediatrics, College of Medicine, Kyunghee University, Seoul, Korea |
| 자기공명영상의 병변에 따른 급성 파종성 뇌척수염의 임상 양상과 예후 |
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정성훈, 박성신, 정사준 |
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경희대학교 의과대학 소아과학교실 |
Correspondence:
Sajun Chung, Email: sajchung@khmc.or.kr
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| Abstract |
Purpose
: Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system and mostly develops after viral illness or vaccinations. We investigated the clinical differences and neurologic outcomes according to the distribution of the lesions on brain MRI.
Methods
: The study group was composed of 21 patients from January 1995 to August 2003 in Kyunghee University hospital. We grouped the patients according to the MRI findings as follows. Group I (14 cases): Multi- or unifocal lesions only in the cerebral white matter. Group II (7 cases): lesions in the gray matter with or without white matter involvement.
Results
: 1. Preceding events were as follows: no defined prodrome (38.1%), upper respiratory tract infection (28.6%), nonspecific febrile illness (19.0%), gastointestinal disturbance and vaccination.
2. Presenting symptoms were as follows: seizures (76.2%), headache/vomiting (47.6%), altered consciousness (38.1%), hemiparesis, cerebellar ataxia, visual disturbance and facial nerve palsy.
3. Laboratory findings were as follows: CSF pleocytosis (76.2%), leucocytosis (38.1%) and elevated CSF protein (28.6%).
4. Fifteen patients were recovered completely without neurological sequelae. Three patients in group I and 1 patient in group II had intractable seizures. Two patients in group I and 2 patients in group II had motor disturbance.
Conclusion
: There were no statistically significant differences in preceding events, presenting symptoms, and neurological outcomes according to the distribution of the lesions on brain MRI. However, the ADEM have quite diverse clinical manifestations and neuroimage findings. MRI plays an important role in making diagnosis of the patients who are suspected of ADEM |
| Key Words:
Encephalomyelitis, White matter, Gray matter, Neurologic outcome |
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