ObjectiveTo summarize the clinical features and analyze the factors of influencing prognosis in children with acute disseminated encephalomyelitis(ADEM).
MethodsThe clinical features of children with ADEM retrospectively analyzed.The children patients were divided into the complete healing group and incomplete healing group.The age, gender, inducements, clinical symptoms, white cell and albumen level in cerebrospinal fluid, electromyogram in extremities and encephalic MRI were compared between two groups, and the factors of influencing prognosis were explored.
ResultsA total of 77 patients(44 male and 33 female), aged range from 4 months 14 days to 14 years old, were investigated.Sixty cases with infection history, 7 cases with vaccination history and 14 cases without definite inducement were found.The major clinical symptoms included the motility disorders of extremities, eclampsia, conscious disturbance, headache and dizziness, and the patients often accompanied by non-specific symptoms of fever.The results of encephalic MRI in 76 cases showed that 66 cases were abnormity, and the results of spinal cord MRI in 56 cases showed that 27 cases were abnormity.The lesion in spinal cord was found in the patients with normal encephalic MRI.Forty-one children(including 31 cases of complete healing group and 10 cases of incomplete healing group) were followed up for 6 months to 6 years after illness.The differences of the age, gender, inducements, clinical symptoms, cerebrospinal fluid white blood cell count and protein level, electromyography of limbs and encephalic MRI between two groups were not statistically significant(P>0.05).
ConclusionsThe acute or subacute onset, encephalopathy, MRI abnormalities in the cranial or spinal cord are the main diagnosis criteria, and the prognosis in most patients are good.The gender, age of onset, predisposition, main clinical symptoms, general examination of cerebrospinal fluid, electromyography of limbs and head MRI do not affect on the prognosis.
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