Multimodal treatment of acute disseminated encephalomyelitis in children

摘要: The chief treatment options for acute disseminated encephalomyelitis (ADEM) include methylprednisolone (MP), plasma exchange (PE), intravenous immunoglobulin (IVIG). However, there is no evidence-based recommendations management of ADEM. To identify the prognosis in ADEM after use different modalities treatment, a 3-year prospective study cases presenting with neurological features temporal relation to an infection or vaccination presumed etiology as demyelination was undertaken. Investigations causative agent, magnetic resonance imaging brain and spinal cord, cerebrospinal fluid studies, electrophysiological blood tests exclude metabolic collagen vascular disorders were done. A standard protocol steroids, failing which (Modified Rankin scale score four 5 at end 3 weeks) IVIG PE given. One patient underwent hemicraniectomy. Cases followed up 1 year. Telephonic interview done 3rd 5th Of 32 (