Factors Related to Long Term Motor, Behavioral, and Scholastic Outcome in Children with Acute Disseminated Encephalomyelitis

• Published in: Pediatric neurology 2018-12, Vol.89, p.49-57
• Main Authors: Iype, Mary, TS, Anish, Kunju, PA Mohammed, Saradakutty, Geetha, Sreedharan, Mini, Ahamed, Shahanaz M
• Format: Article
• Language: English
• Subjects: Acute disseminated encephalomyelitis; Analysis of Variance; Child; Child Behavior Disorders - etiology; Child, Preschool; Cohort Studies; Educational Status; Encephalomyelitis, Acute Disseminated - complications; Encephalomyelitis, Acute Disseminated - psychology; Female; Humans; Infant; Language Disorders - etiology; Long term prognosis; Male; Motor and cognitive sequelae; Motor Disorders - etiology; Pediatric demyelination; Predictive Value of Tests; Regression Analysis
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2018.08.015

We studied the long-term outcome of Acute disseminated encephalomyelitis (ADEM). We performed a retrospective cohort study among children diagnosed with ADEM (fulfilling IPMSSG criteria). Major outcome variables were motor deficit, scholastic underperformance, and behavioral abnormality. The inclusion criteria were fulfilled by 102 children. Three died in hospital. The follow-up ranged from one to 10 years (median 4 years). Motor deficit was seen in 17(17.2%), attention deficit in 25 (25.3%), behavioral abnormality in 13(13.1%), persistent seizures in seven (7%) invididuals and poor learning skills in 22 (22.2%). Recurrence of demyelination occurred in seven (7.1%). Two individuals had a recurrent demyelinating disorder (a chronic relapsing demyelinating disorder) that could not be classified as multiple sclerosis (MS), two had ADEM with sequential optic neuritis and three had multiphasic ADEM. At follow-up, the mean (SD) modified Rankin Scale (mRS) score was 0.556 (1.36) and Expanded Disability Status Scale score was 1.71(2.22). On multivariate analysis, the mRS score at discharge (p