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急性播散性脑脊髓炎的神经心理学结局。

Neuropsychological outcome in cases with acute disseminated encephalomyelitis.

机构信息

Division of Child Neurology, Ege University Faculty of Medicine, İzmir, Turkey.

Department of Pediatrics, Child and Adolescent Psychiatry, Ege University Faculty of Medicine, İzmir, Turkey.

出版信息

Turk J Pediatr. 2020;62(4):594-605. doi: 10.24953/turkjped.2020.04.009.

Abstract

BACKGROUND AND OBJECTIVES

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated, inflammatory and demyelinating disorder of the central nervous system. There have been a few studies in recent years on the fact that these cases have neurocognitive impairment. The purpose of this study is to evaluate the neurocognitive outcome and quality of life in cases with ADEM.

METHODS

Eleven cases who were on follow-up between 2008 and 2017 were included in the study, systemic, neurological and psychiatric examinations were done. All magnetic resonance images were re-evaluated. The neuropsychiatric evaluation was performed by clinical examination and psychometric scales; (1) The Pediatric Quality of Life Inventory 4.0, (2) Child Behavior Checklist, (3) Children`s Depression Inventory, (4) The Wechsler Intelligence Scale for Children-Revised and (5) Continuous Performance Test. The cases in our study underwent neuropsychiatric evaluation 3-42 months after the diagnosis of ADEM had been established.

RESULTS

Nine cases (81.8%) fully recovered without neurologic deficit. One case (9.1%) had a psychiatric disorder. During follow-up, cognitive and psychiatric problems were encountered in half of the cases (54.5%). Most of the cases with basal ganglia involvement (80%) displayed attention deficit and cognitive problems.

CONCLUSION

In particular, cases with basal ganglia involvement should be followed carefully in terms of attention and cognitive problems.

摘要

背景与目的

急性播散性脑脊髓炎(ADEM)是一种中枢神经系统的免疫介导、炎症性和脱髓鞘性疾病。近年来,有一些研究表明,这些病例存在神经认知障碍。本研究旨在评估 ADEM 患者的神经认知结局和生活质量。

方法

本研究纳入了 2008 年至 2017 年间接受随访的 11 例患者,进行了系统、神经和精神检查。所有磁共振图像均重新评估。神经精神评估通过临床检查和心理计量量表进行:(1)儿童生活质量问卷 4.0 版,(2)儿童行为检查表,(3)儿童抑郁量表,(4)韦氏儿童智力量表修订版,(5)连续操作测试。我们的研究中的病例在 ADEM 诊断确立后 3-42 个月接受神经精神评估。

结果

9 例(81.8%)患者完全康复,无神经功能缺损。1 例(9.1%)患者有精神障碍。随访期间,一半的病例(54.5%)出现认知和精神问题。大多数基底节受累的病例(80%)表现出注意力缺陷和认知问题。

结论

特别是有基底节受累的病例应特别注意注意力和认知问题。

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