Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction Acute disseminated encephalomyelitis (ADEM) is an immune mediated disease of the brain. Although it occurs in all ages, most reported cases are in children and adolescents.The aim of this study was to assess the clinical characterization, neuroimaging and outcome of ADEM in children in Pediatric Hospital of Cairo University. Methods This observational study was carried out from January 2016 to December 2016 in the Pediateric Hospital of Cairo University. All children diagnosed as ADEM during a one year period were included in the study. All studied cases were followed up and reevaluated at three months . we use SPSS version 22 and Chi square, t{u2012}test for data analysis. Results Twenty children were included in this study (12 male and 8 female), the average age was 4.6 +3.2 years. Prodroma was found in 55% of the cases while the commonest presentation were motor defecits (as ataxia, paraparesis, hemiparesis and monoparesis), convulsions (either generalized or focal or even status epilepticus) and altered consciousness. Demyelination patches were multifocal In 80%, mainly subcortical white matter lesions which were bilateral and asymmetric in location and size. Assessment after 3 months follow up showed 55% full recovery, 25% were cured with remaining neurological defecits,15% relapse and 5% death. The predictors of better outcome were children with higher GCS (6{u2012}14) (p=0.023 ) Conclusion The clinical pattern of Acute disseminated encephalomyelitis is variable and motor defecits was the common presentation. The outcome is generaly favorable

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