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The Epidemiologic and Demographic Characteristics and Clinical Findings in Patients With Acute Disseminated Encephalomyelitis (Adem) Referred to Alzahra Hospital, Isfahan, Iran, During 10 Years (2003-2013)



Etemadifar M1 ; Kadkhodaei F2 ; Najafi M1
Authors
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Authors Affiliations
  1. 1. Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Student of Medicine, School of Medicine and Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Isfahan Medical School Published:2015

Abstract

Background: Acute disseminated encephalomyelitis (ADEM) is an uncommon monophasic disease often with good prognosis. It is a differential diagnosis of multiple sclerosis (MS). Accurate distinction between acute disseminated encephalomyelitis and multiple sclerosis is important for prognosis and treatment; as many patients with multiple sclerosis may benefit from early disease-modifying therapy to suppress ongoing and future relapses. Methods: In a retrograde study, all the patients presented to Alzahra hospital (Isfahan, Iran) with definite diagnosis of acute disseminated encephalomyelitis during a 10-year period were included. Demographic data, clinical signs and symptoms, and laboratory and imaging findings were collected and analyzed using t and chi-square tests via SPSS software. Findings: Forty-two patients with mean age of 20.05 ± 10.04 years and a female-predominance of 64.3% participated in the study. Thirty-three patients (78.6%) had a recent history of infectious disease. A seasonal pattern of distribution in spring (31%) and autumn (31%) was seen. The cerebrospinal fluid (CSF) analysis findings showed pleocytosis and increased protein in 26 (61.9%) and 25 (59.6%) cases, respectively. First magnetic resonance imaging (MRI) findings revealed that most of the lesions were in the periventricular (83%) and re-imaging in 25 cases showed completely or partially resolution of previous lesions with no new lesion in 18 (72%) and 7 (28%) patients, respectively. Conclusion: We found some controversies to previous studies in epidemiological and imaging studies which could be of a significant role in detecting and accurate diagnosis of acute disseminated encephalomyelitis which can significantly impact on physicians’ view of the disease. © 2015 Isfahan University of Medical Sciences(IUMS). All rights reserved.
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