Diagnostic criteria of acute disseminated encephalomyelitis (ADEM) in children

Clinical features (all are required)

A first polyfocal, clinical central nervous system event with presumed inflammatory demyelinating cause

Encephalopathy that cannot be explained by fever, systemic illness, or postictal symptoms

No new clinical and MRI findings emerge three months or more after the onset

Brain MRI is abnormal during the acute (three-month) phase

Lesion characteristics on brain MRI

Diffuse, poorly demarcated, large (>1 to 2 cm) lesions involving predominantly the cerebral white matter

Deep gray matter lesions (eg, involving the basal ganglia or thalamus) can be present

T1 hypointense lesions in the white matter are rare

The clinical features of ADEM typically follow a monophasic disease course, although they can fluctuate in severity and evolve in the first three months following disease onset. Multiphasic ADEM is defined as two episodes consistent with ADEM separated by three months but not followed by any further events. The second ADEM event can involve either new or a re-emergence of prior neurologic symptoms, signs and MRI findings.

Adapted from: Krupp LB, Tardieu M, Amato MP, et al. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult Scler 2013; 19:1261.

Graphic 74896 Version 4.0

خرید پکیج

Diagnostic criteria of acute disseminated encephalomyelitis (ADEM) in children