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急性播散性脑脊髓炎:15例儿童病例分析

Acute disseminated encephalomyelitis: an evaluation of 15 cases in childhood.

作者信息

İncecik Faruk, Hergüner M Özlem, Altunbaşak Şakir

机构信息

Division of Pediatric Neurology, Department of Pediatrics, Çukurova University Faculty of Medicine, Adana, Turkey.

出版信息

Turk J Pediatr. 2013 May-Jun;55(3):253-9.

Abstract

To describe our experience with acute disseminated encephalomyelitis (ADEM) and the relationships between the clinical course, magnetic resonance imaging (MRI) findings and treatment, a retrospective record review was conducted of 15 children who were admitted with the diagnosis of ADEM during the period 2004-2010. Their ages ranged between 2 and 13 years. Patients presented most often with ataxia (53.3%) and secondly with weakness and headache (46.6%). Myelitis was determined in two patients. Five patients were treated with high-dose intravenous (IV) methylprednisolone followed by oral prednisolone, seven patients were treated with oral prednisolone, one patient was treated with plasmapheresis with IV immunoglobulin (Ig), and one patient was treated with IVIg. We observed recurrence in one patient. ADEM is a demyelinating disorder that is being diagnosed increasingly more as MRI studies are performed more frequently in patients with acute encephalopathy. Early diagnosis and therapy might improve the outcome.

摘要

为描述我们对急性播散性脑脊髓炎(ADEM)的诊疗经验以及临床病程、磁共振成像(MRI)表现与治疗之间的关系,我们对2004年至2010年期间收治的15例诊断为ADEM的儿童进行了回顾性病历审查。他们的年龄在2岁至13岁之间。患者最常表现为共济失调(53.3%),其次是无力和头痛(46.6%)。两名患者被诊断为脊髓炎。5例患者接受大剂量静脉注射甲基泼尼松龙治疗,随后口服泼尼松龙;7例患者接受口服泼尼松龙治疗;1例患者接受血浆置换联合静脉注射免疫球蛋白(Ig)治疗;1例患者接受静脉注射免疫球蛋白治疗。我们观察到1例患者复发。随着对急性脑病患者更频繁地进行MRI检查,ADEM这种脱髓鞘疾病的诊断越来越多。早期诊断和治疗可能会改善预后。

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