Clinical Presentation and outcome of acute disseminated encephalomyelitis in Saudi Arabia. Tertiary Center Experience

Neurosciences (Riyadh). 2019 Apr;24(2):89-94. doi: 10.17712/nsj.2019.2.20180017.

Abstract

Objective: To evaluate the clinical presenation of acute disseminated Encephalomyelitis (ADEM) in pediatric age group, treatments, and to asses the outcome at King Abdulaziz Medical City, Riyadh, Kingdom of Saudia Arabia.

Methods: The medical records of all patients younger than 18 years of age with a diagnosis of ADEM and treated at King Abdulaziz Medical City from January 1996 to Decemeber 2016 were collected. A total of 20 patients were included.

Results: Of 20 patients enrolled in our study, 13 (65%) were female. Autumn and summer were the most common seasons in which ADEM presented (60%); 19 (95%) patients had a history of preceding viral illnesses. The most common neurological deficits on presentation were weakness (85%), ataxia (45%), and nystagmus (45%). Cortical and subcortical lesions (60%) were the most common finding on cranial magnetic resonance imaging. Seventeen patients (85%) received steroid only. Only 16 patients continued with follow-up, with a mean duration of 7 months. All 16 patients improved: 11 patients were recovered and 5 patients still had a neurological deficit at the clinic visits. No patient had relapsed.

Conclusion: Most of the patients in this case series have an excellent outcome and attended follow-up visits and no disease relapses were identified. Further exploration of the disease is recommended.

MeSH terms

  • Adolescent
  • Brain / diagnostic imaging
  • Brain / pathology
  • Child
  • Child, Preschool
  • Encephalomyelitis, Acute Disseminated / diagnosis
  • Encephalomyelitis, Acute Disseminated / epidemiology*
  • Encephalomyelitis, Acute Disseminated / pathology
  • Female
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Saudi Arabia / epidemiology
  • Seasons
  • Tertiary Care Centers / statistics & numerical data
  • Tertiary Healthcare / statistics & numerical data