Clinical Profles and Short-Term Outcomes of Acute Disseminated Encephalomyelitis in Adult Chinese Patients
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Background and PurposezzAcute disseminated encephalomyelitis (ADEM) is an infammatory demyelinating disorder that predominantly afects children. Previous studies have mostly involved children in Western developed countries. MethodszzTis study retrospectively reviewed the clinical profles of ADEM in adult Chinese patients. ResultszzADEM occurred during summer and autumn in about two-thirds of the 42 included patients. Prior infection was found in fve patients and no preimmunization was recorded. Te most frequent clinical presentations were alterations in consciousness (79%) and behavior changes (69%), followed by motor defcits (64%) and fever (50%). About one-quarter (26%) of the patients showed positive results for oligoclonal bands, and about half of them exhibited increases in the IgG index and 24-hour IgG synthesis rate. Magnetic resonance imaging showed white- and gray-matter lesions in 83% and 23% of the patients, respectively. Steroids were the main treatment, and full recovery occurred in 62% of the patients, with residual focal neurological defcits recorded in a few patients. Afer a mean follow-up period of 3.4 years, two patients exhibited recurrence and one patient exhibited a multiphasic course. One patient was diagnosed with multiple sclerosis (MS). ConclusionszzWith the exception of the seasonal distribution pattern and prior vaccine rate, the clinical profles of ADEM in adult Chinese patients are similar to those in pediatric populations. No specifc markers are available for distinguishing ADEM from MS at the initial presentation. Careful clinical evaluations, cerebrospinal fuid measurements, and neuroradiological examinations with long-term follow-up will aid the correct diagnosis of ADEM.
Abstract
Background and PurposezzAcute disseminated encephalomyelitis (ADEM) is an infammatory demyelinating disorder that predominantly afects children. Previous studies have mostly involved children in Western developed countries. MethodszzTis study retrospectively reviewed the clinical profles of ADEM in adult Chinese patients. ResultszzADEM occurred during summer and autumn in about two-thirds of the 42 included patients. Prior infection was found in fve patients and no preimmunization was recorded. Te most frequent clinical presentations were alterations in consciousness (79%) and behavior changes (69%), followed by motor defcits (64%) and fever (50%). About one-quarter (26%) of the patients showed positive results for oligoclonal bands, and about half of them exhibited increases in the IgG index and 24-hour IgG synthesis rate. Magnetic resonance imaging showed white- and gray-matter lesions in 83% and 23% of the patients, respectively. Steroids were the main treatment, and full recovery occurred in 62% of the patients, with residual focal neurological defcits recorded in a few patients. Afer a mean follow-up period of 3.4 years, two patients exhibited recurrence and one patient exhibited a multiphasic course. One patient was diagnosed with multiple sclerosis (MS). ConclusionszzWith the exception of the seasonal distribution pattern and prior vaccine rate, the clinical profles of ADEM in adult Chinese patients are similar to those in pediatric populations. No specifc markers are available for distinguishing ADEM from MS at the initial presentation. Careful clinical evaluations, cerebrospinal fuid measurements, and neuroradiological examinations with long-term follow-up will aid the correct diagnosis of ADEM.
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