TURK PEDIATRI ARSIVI-TURKISH ARCHIVES OF PEDIATRICS, cilt.40, sa.3, ss.199-203, 2005 (ESCI)
Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system in studies of childhood ADEM. In studies of childhood, ADEM documented prodromal viral illness, or vaccination history is present in approximately three-quarters of the subjects. Diagnosis is based on clinical and radiological findings. Magnetic Resonance Imaging (MRI) of the brain is the investigation of choice and typically demonstrates white matter changes, though grey matter may be involved. Involvement of the deep grey matter, particularly basal ganglia, is more frequent. In the absence of clinical recurrence, new MRI lesions that appear beyond the first few months after ADEM may help in the early diagnosis of multiple sclerosis (MS). In contrast to MS, ADEM is usually a monophasic disorder with favourable long-term prognosis. If relapses are thought to represent part of the same acute monophasic immune process, the term 'multiphasic disseminated encephalomyelitis' (MDEM) is used. High-dose intravenous methylprednisolon has been found to be effective. If that fails, immunoglobulins, plasmapheresis, or cytotoxic drugs can be administered.