Article

Multiple sclerosis vs acute disseminated encephalomyelitis in childhood

Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
Pediatric Neurology (Impact Factor: 1.5). 10/2003; 29(3):227-31. DOI: 10.1016/S0887-8994(03)00235-2
Source: PubMed

ABSTRACT The initial presenting clinical and laboratory findings of either acute disseminated encephalomyelitis or the first attack of multiple sclerosis in the pediatric population were compared and contrasted. A retrospective review of the medical records was conducted of all children younger than 17 years who presented with either the diagnosis of acute disseminated encephalomyelitis or multiple sclerosis between 1987 and 2001. Seventeen cases of clinically definite multiple sclerosis (seven female, mean age 12.4 +/- 4.5 years) and seven cases of acute disseminated encephalomyelitis (three female; mean age 8.7 +/- 3.8 years) were reviewed. Systemic and nonfocal neurologic symptoms were more commonly evident in acute disseminated encephalomyelitis than in multiple sclerosis: fever (43% vs 6%), headache (57% vs 24%), fatigue (71% vs 29%), vomiting (57% vs 0%), and encephalopathy (71% vs 6%). In multiple sclerosis patients, T(2)-weighted white matter magnetic resonance imaging lesions were more commonly located in the corpus callosum (64% vs 17%) and the periventricular area (91% vs 50%) compared with those in patients with acute disseminated encephalomyelitis. These results suggest that acute disseminated encephalomyelitis and multiple sclerosis can be differentiated to some degree according to clinical and radiologic data at initial presentation, which is important because the long-term prognosis for childhood multiple sclerosis appears to be less favorable.

0 Followers
 · 
105 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Las encefalitis agudas infantiles son infecciones no supuradas del parénquima cerebral que suelen deberse a una infección viral. Se distinguen dos tipos según su patogenia: las encefalitis primarias y las postinfecciosas. Las encefalitis primarias se deben a la replicación del virus en el seno del parénquima cerebral. Una de las principales formas es la encefalitis herpética, que provoca una síntesis intratecal de anticuerpos antiherpéticos de forma diferida y duradera, lo que permite un diagnóstico retrospectivo. En la fase aguda, la reacción en cadena de la polimerasa (PCR) constituye el método diagnóstico de elección de la encefalitis herpética. El tratamiento de esta enfermedad se basa en aciclovir por vía intravenosa. Su eficacia es mayor cuanto antes se instaure. Las encefalitis postinfecciosas o encefalitis agudas diseminadas son las más frecuentes, y se deben a una disregulación inmunitaria desencadenada por el virus, que se dirige contra algunos componentes del parénquima cerebral, sin contaminación directa de las células cerebrales. Las manifestaciones clínicas suelen comenzar de forma súbita, varios días o semanas después de una infección o de una vacunación, y consisten en una alteración del nivel de conciencia, crisis convulsivas y signos de déficit neurológicos en un niño afebril o con poca fiebre. Estos síntomas no son específicos de las encefalitis y pueden encontrarse en otras infecciones del sistema nervioso central, como las meningitis bacterianas y los abscesos cerebrales, que requieren un tratamiento específico urgente. El tratamiento curativo de la encefalitis postinfecciosa es esencialmente sintomático, pero la vacunación contra algunas infecciones virales, como el sarampión, la rubéola y la parotiditis, constituye la mejor prevención.
    01/2007; 42(2):1–14. DOI:10.1016/S1245-1789(07)70251-2
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Multiple sclerosis (MS) starting in childhood and adolescence poses a challenge for diagnosis and management of the disease. The aim of the present study was to assess the characteristics of early onset MS in Brazilian patients. Methods Retrospective data collection from specialized MS units. Results From 20 MS units in 11 Brazilian states, 117 cases of MS starting before the age of 18 years were collected. These patients had an average of 10 years of disease duration, still typically with low disability and one relapse every 2.5 years. The mean age for disease onset was 13.7 years. Conclusion The present study introduces a large series of Brazilian cases of pediatric MS. Although some patients presented a very severe form of MS, on the whole the group of patients with MS starting in childhood or adolescence presented a relatively mild form of this disease in Brazil.
    Arquivos de neuro-psiquiatria 10/2013; 71(10):783-7. DOI:10.1590/0004-282X20130122 · 1.01 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Motor and somatosensory evoked potentials (MEPs and SSEPs) are sensitive tools for detecting subclinical lesions, assessing disease severity, and determining the prognosis for outcomes of patients with inflammatory neurological diseases such as multiple sclerosis. However, their roles in neuromyelitis optica (NMO), a severe inflammatory neurological disease that predominantly involves optic nerves and spinal cord, have not yet been clarified. Clinical symptoms and examination findings at relapses of 30 NMO patients were retrospectively reviewed. Abnormal MEPs were observed in 69.2% of patients. Patients with abnormal motor central conduction time (CCT) of the lower limbs had higher Kurtzke Expanded Disability Status Scale (EDSS) scores than those with normal responses (P = 0.027). Abnormal SSEPs were found in 69.0% of patients. Patients with abnormal lower limb sensory CCT had higher EDSS scores than those with normal responses (P = 0.019). In 28 patients followed up more than 6 months, only one of 11 patients (9.1%) with normal SSEPs of the lower limbs had new relapses within 6 months, whereas 8 of 17 patients (47.1%, P = 0.049) with abnormal SSEPs of the lower limbs had new relapses. These results indicate MEPs and SSEPs of the lower limbs are good indicators for the disability status at relapses of NMO. Lower limb SSEPs may be a good tool for reflecting the frequency of relapses of NMO.
    PLoS ONE 11/2014; 9(11):e113631. DOI:10.1371/journal.pone.0113631 · 3.53 Impact Factor

Full-text (2 Sources)

Download
40 Downloads
Available from
May 16, 2014