Acute disseminated encephalomyelitis in children: Characteristics of cases in Jordan

Abstract

Our purpose is to describe the clinical, neuroradiologic features and outcome of patients with acute encephalomyelitis (ADEM) from Jordan, a developing country, and to compare the findings to other reports from the developed and developing countries. A retrospective review was conducted of the medical records and magnetic resonance imaging (MRI) findings of children who presented to any of the three hospitals that were involved in the study in Jordan from 2002 to 2005. Eleven children were diagnosed with ADEM by clinical and MRI findings. All were treated with steroids and evaluated at 6–24 month follow-up. Three of the children (27% presented with a history of recent upper respiratory tract infection, but none presented with a recent history of vaccination. Prodromal signs and symptoms were reported in only six (55% of the children. All the children except one had a motor deficit. Only three (27% of the children had abnormal cerebrospinal fluid (CSF) findings and eight had normal results. MRI lesions were most commonly bilateral and asymmetric but varied in shape and size. The use of methylprednisolone was usually associated with reasonable recovery. Nine patients (82%) recovered completely while two children recovered with sequelae. Compared to reports from developed countries, this series has a lower prevalence of preceding non-specific infection and a higher prevalence of normal CSF findings. These findings may be related to a difference in etiologic pathogens. Therefore, a larger regional multicenter study is highly recommended.

Keywords

Encephalomyelitis - children - Jordan