Masoud Etemadifar, Amir Neshatfar, Yalda Nikanpour and Mehri Salari
Background: Acute Disseminated Encephalomyelitis (ADEM) is an inflammatory disease of the central nervous system which affects white matter and leads to a polysymptomatic disease with clinical signs and symptoms.
Aim: The present study was initiated to report on the various modes of presentation and raises the awareness of the diagnosis of ADEM.
Methods: In this retrospective study, we assessed the characteristics of the disease in an Iranian population during a period of 10 years (2005-2015) whit at least 2 years follow up. All patients presenting to Alzahra Hospital, Isfahan, Iran, with a high probability of diagnosis of ADEM. Their demographic, clinical, laboratory, and imaging data were collated and analyzed by performing the t-test and chi-square test using SPSS25 software.
Results: Forty-seven patients with a mean age of 14.7 ± 10.04 years and a female predominance participated in this study. Most patients had a recent history of infectious disease (37 cases) or vaccination (5 cases). Seasonality in incidence with predominance in spring (31.9%) and winter (29.7%) was also noted. CSF analysis was normal in 14.8% cases and 27 patients were found to have pleocytosis. MRI data revealed that most lesions were in the cortical, periventricular, and basal ganglia areas. Re-imaging showed complete (34 patients) or partial (13 patients) resolution of previous lesions with no new lesions in next follow up MRI.
Conclusion: We found some disagreement with previous epidemiologic and imaging studies that could be of significance in the detection and understanding of ADEM.