Acute demyelinating encephalomyelitis: Clinical characteristics and outcome
Identifieur interne : 000386 ( Ncbi/Merge ); précédent : 000385; suivant : 000387Acute demyelinating encephalomyelitis: Clinical characteristics and outcome
Auteurs : Ahmed Farag Elhassanien [Égypte] ; Hesham Abdel Aziz [Égypte]Source :
- Journal of Pediatric Neurosciences [ 1817-1745 ] ; 2013.
Abstract
ADEM, although relatively uncommon, is probably under-recognized.
To spotlight the clinical profile and therapeutic outcome of children with ADEM.
This is a prospective study of patients with ADEM who were admitted to the Pediatric Departments in Aladan and Alfarawanya Hospitals in Kuwait, from January 2009 to January 2011. Clinical, microbiological and radiological data were analyzed.
Of 48 patients presented with acute neurological symptoms and signs, 21 patients fulfilled criteria for ADEM. 80.95% of cases were presenting in winter and spring, 57% of patients had a history of upper respiratory tract illness. The commonest presentations were motor deficits, convulsions and altered consciousness. CSF virology studies showed herpes simplex virus (HSV) and Epstein-Barr virus (EBV) (3 patients) whereas nasal and nasopharyngeal swab showed evidence of influenza H1N1 virus (1 patient). Brain MRI was performed in all patients and revealed multiple hyperintense supratentorial brain lesions on T2/FLAIR images. 85.7% of patients had cortical and/or subcortical white matter lesions which were bilateral and asymmetric in location and size.
ADEM although rare must be considered in children with acute onset of neurological signs and symptoms and must be distinguished from any acute neurological insult.
Url:
DOI: 10.4103/1817-1745.111418
PubMed: 23772240
PubMed Central: 3680891
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<author><name sortKey="Elhassanien, Ahmed Farag" sort="Elhassanien, Ahmed Farag" uniqKey="Elhassanien A" first="Ahmed Farag" last="Elhassanien">Ahmed Farag Elhassanien</name>
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<author><name sortKey="Aziz, Hesham Abdel" sort="Aziz, Hesham Abdel" uniqKey="Aziz H" first="Hesham Abdel" last="Aziz">Hesham Abdel Aziz</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Faculty of Medicine, Benha University, Egypt</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Acute demyelinating encephalomyelitis: Clinical characteristics and outcome</title>
<author><name sortKey="Elhassanien, Ahmed Farag" sort="Elhassanien, Ahmed Farag" uniqKey="Elhassanien A" first="Ahmed Farag" last="Elhassanien">Ahmed Farag Elhassanien</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Faculty of Medicine, Elmansoura University, Egypt</nlm:aff>
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<wicri:noRegion>Elmansoura University</wicri:noRegion>
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<author><name sortKey="Aziz, Hesham Abdel" sort="Aziz, Hesham Abdel" uniqKey="Aziz H" first="Hesham Abdel" last="Aziz">Hesham Abdel Aziz</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Faculty of Medicine, Benha University, Egypt</nlm:aff>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Faculty of Medicine, Benha University</wicri:regionArea>
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title>
<p>ADEM, although relatively uncommon, is probably under-recognized.</p>
</sec>
<sec id="st2"><title>Objectives:</title>
<p>To spotlight the clinical profile and therapeutic outcome of children with ADEM.</p>
</sec>
<sec id="st3"><title>Materials and Methods:</title>
<p>This is a prospective study of patients with ADEM who were admitted to the Pediatric Departments in Aladan and Alfarawanya Hospitals in Kuwait, from January 2009 to January 2011. Clinical, microbiological and radiological data were analyzed.</p>
</sec>
<sec id="st4"><title>Results:</title>
<p>Of 48 patients presented with acute neurological symptoms and signs, 21 patients fulfilled criteria for ADEM. 80.95% of cases were presenting in winter and spring, 57% of patients had a history of upper respiratory tract illness. The commonest presentations were motor deficits, convulsions and altered consciousness. CSF virology studies showed herpes simplex virus (HSV) and Epstein-Barr virus (EBV) (3 patients) whereas nasal and nasopharyngeal swab showed evidence of influenza H1N1 virus (1 patient). Brain MRI was performed in all patients and revealed multiple hyperintense supratentorial brain lesions on T2/FLAIR images. 85.7% of patients had cortical and/or subcortical white matter lesions which were bilateral and asymmetric in location and size.</p>
</sec>
<sec id="st5"><title>Conclusion:</title>
<p>ADEM although rare must be considered in children with acute onset of neurological signs and symptoms and must be distinguished from any acute neurological insult.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Pediatr Neurosci</journal-id>
<journal-id journal-id-type="iso-abbrev">J Pediatr Neurosci</journal-id>
<journal-id journal-id-type="publisher-id">JPN</journal-id>
<journal-title-group><journal-title>Journal of Pediatric Neurosciences</journal-title>
</journal-title-group>
<issn pub-type="ppub">1817-1745</issn>
<issn pub-type="epub">1998-3948</issn>
<publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name>
<publisher-loc>India</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23772240</article-id>
<article-id pub-id-type="pmc">3680891</article-id>
<article-id pub-id-type="publisher-id">JPN-8-26</article-id>
<article-id pub-id-type="doi">10.4103/1817-1745.111418</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Acute demyelinating encephalomyelitis: Clinical characteristics and outcome</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Elhassanien</surname>
<given-names>Ahmed Farag</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Aziz</surname>
<given-names>Hesham Abdel</given-names>
</name>
<xref ref-type="aff" rid="aff2">1</xref>
</contrib>
</contrib-group>
<aff id="aff1">Faculty of Medicine, Elmansoura University, Egypt</aff>
<aff id="aff2"><label>1</label>
Faculty of Medicine, Benha University, Egypt</aff>
<author-notes><corresp id="cor1"><bold>Address for correspondence:</bold>
Dr. Ahmed Farag Elhassanien, Faculty of Medicine, Elmansoura University, Egypt. E-mail: <email xlink:href="ahmedfaraj66@yahoo.com">ahmedfaraj66@yahoo.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><season>Jan-Apr</season>
<year>2013</year>
</pub-date>
<volume>8</volume>
<issue>1</issue>
<fpage>26</fpage>
<lpage>30</lpage>
<permissions><copyright-statement>Copyright: © Journal of Pediatric Neurosciences</copyright-statement>
<copyright-year>2013</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec id="st1"><title>Background:</title>
<p>ADEM, although relatively uncommon, is probably under-recognized.</p>
</sec>
<sec id="st2"><title>Objectives:</title>
<p>To spotlight the clinical profile and therapeutic outcome of children with ADEM.</p>
</sec>
<sec id="st3"><title>Materials and Methods:</title>
<p>This is a prospective study of patients with ADEM who were admitted to the Pediatric Departments in Aladan and Alfarawanya Hospitals in Kuwait, from January 2009 to January 2011. Clinical, microbiological and radiological data were analyzed.</p>
</sec>
<sec id="st4"><title>Results:</title>
<p>Of 48 patients presented with acute neurological symptoms and signs, 21 patients fulfilled criteria for ADEM. 80.95% of cases were presenting in winter and spring, 57% of patients had a history of upper respiratory tract illness. The commonest presentations were motor deficits, convulsions and altered consciousness. CSF virology studies showed herpes simplex virus (HSV) and Epstein-Barr virus (EBV) (3 patients) whereas nasal and nasopharyngeal swab showed evidence of influenza H1N1 virus (1 patient). Brain MRI was performed in all patients and revealed multiple hyperintense supratentorial brain lesions on T2/FLAIR images. 85.7% of patients had cortical and/or subcortical white matter lesions which were bilateral and asymmetric in location and size.</p>
</sec>
<sec id="st5"><title>Conclusion:</title>
<p>ADEM although rare must be considered in children with acute onset of neurological signs and symptoms and must be distinguished from any acute neurological insult.</p>
</sec>
</abstract>
<kwd-group><kwd>Acute disseminated encephalomyelitis</kwd>
<kwd>multifocal demyelination</kwd>
<kwd>immunosuppressive therapy</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Égypte</li>
</country>
</list>
<tree><country name="Égypte"><noRegion><name sortKey="Elhassanien, Ahmed Farag" sort="Elhassanien, Ahmed Farag" uniqKey="Elhassanien A" first="Ahmed Farag" last="Elhassanien">Ahmed Farag Elhassanien</name>
</noRegion>
<name sortKey="Aziz, Hesham Abdel" sort="Aziz, Hesham Abdel" uniqKey="Aziz H" first="Hesham Abdel" last="Aziz">Hesham Abdel Aziz</name>
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