Acute disseminated encephalomyelitis in children and adolescents – 20-year single-center experience in Serbia

Abstract

Introduction/Objective Acute disseminated encephalomyelitis (ADEM) is the most common demyelinat-ing disease of the central nervous system in pediatric patients. We aimed to evaluate the clinical profile of children with ADEM and to discern prognostic factors for disease outcome. Methods A 20-year retrospective–prospective study was conducted in a cohort with the diagnosis of ADEM. Results The study included 36 patients, with range of follow-up period of 6–120 months (median of 26 months). Prior infection was reported in 72.2% of the patients. In the clinical presentation of the disease, motor deficit was most common (81.1%), followed by ataxia (77.8%). More than a third of patients had back and limb pain or abdominal visceral pain, which highly correlated with MRI findings of myelitis. Abnormal brain CT findings were evident in 22.2% of the patients, and this was associated with higher Expanded Disability Status Scale (EDSS) and quicker progression of the disease. Median EDSS was 0 at the most recent follow-up visit, in all the patients. EDSS 0–2.5 was verified in 29 (80.6%) of the patients, while three (8.3%) patients scored 7–9.5 at the last visit. Two patients had a lethal outcome. Conclusions ADEM is a serious disease in pediatric patients, but with a good prognosis, which is illustrated by the fact that 80.6% of our patients had a complete or almost complete recovery. © 2022, Serbia Medical Society. All rights reserved.