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Prediction of Multiphase Alternative of Acute Disseminated Encephalomyelitis Course Development

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DOI: 10.4236/wjns.2014.42011    2,307 Downloads   3,251 Views  

ABSTRACT

Prediction of development of the multi-phase alternative for the course inherent to acute disseminated encephalomyelitis (ADEM) is of great clinical importance, as it enables timely determination of the treatment tactics as well as volume of respective therapeutic interventions. This work is aimed at ascertaining the prognostic factors that determine the risk of development of the multi-phase course in disseminated encephalomyelitis. We have examined 101 patients with the diagnosis ADEM, namely: 28 men and 73 women in the age from 17 up to 53 years (average value 31.7 ± 1.01 years). To ascertain the prognostic meaning of clinic-paraclinic indices corresponding to patients with ADEM, we estimated the cumulative part of absence of relapses in the group of patients by using the Kaplan-Meyer method with estimating the Fisher criterion and using the most important clinic-paraclinic data. Development of the multiphase course in ADEM is reliably related to the following prognostic signs: changes in the neurologic status of patients with ADEM, degree of disability in accord with the EDSS scale as well as sizes of demyelination focuses determined using MRT. Criteria for congenial prediction in disease development with delayed appearance of ADEM relapses in the form of the multi-phase course are as follows: domination of motor impairments over coordinative impairments in neurological status, slight degree (in EDSS scale) of disability and small sizes (up to 4 mm) of demyelination focuses (MRT data). Our analysis of the main clinic-paraclinic indices obtained using the Kaplan-Meyer method indicates reliability of results and enables us to find a number of important prognostic criteria for appearance of the multiphase course in ADEM.

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Lobanova, I. and Myalovitska, O. (2014) Prediction of Multiphase Alternative of Acute Disseminated Encephalomyelitis Course Development. World Journal of Neuroscience, 4, 92-98. doi: 10.4236/wjns.2014.42011.

References

[1] Tenembaum, S. (2008) Disseminated Encephalomyelitis in Children. Clinical Neurology and Neurosurgery, 110, 928-938. http://dx.doi.org/10.1016/j.clineuro.2007.12.018
[2] Brass, S.D. (2003) Multiple Sclerosis and Acute Disseminated Encephalomyelitis in Childhood. Pediatric Neurology, 29, 227-231. http://dx.doi.org/10.1016/S0887-8994(03)00235-2
[3] McGovern, R.A. and DiMario, F.J. (2003) Acute Disseminated Encephalomyelitis: A Retrospective Pediatric Serie. Annals of Neurology, 54, 127-129.
[4] Neuteboom, R.F, Catsman-Berrevoets, C.E. and Hintzen, R.Q. (2007) Multiple Sclerosis in Children. Nederlands Tijdschrift voor Geneeskunde, 151, 1464-1468.
[5] Pohl, D, Hennemuth, I. and Kries, R. (2007) Paediatric Multiple Sclerosis and Acute Disseminated Encephalomyelitis in Germany: Results of a Nationwide Survey. European Journal of Pediatrics, 166, 405-412.
http://dx.doi.org/10.1007/s00431-006-0249-2
[6] Toshiyuki, O. and Shunsaku, H. (2004) Reccurence of Acute Disseminated Encephalomyelitis after a 12-Year Symptom-Free Interval. Interval Medicine, 43, 746-749. http://dx.doi.org/10.2169/internalmedicine.43.746
[7] Tur, C, Téllez, N. and Rovira, A. (2008) Acute Disseminated Encephalomyelitis: Study of Factors Involved in a Possible Development towards Multiple Sclerosis. Neurologia, 23, 546-554.
[8] Hung, K.L. (2001) The Spectrum of Postinfectious Encephalomyelitis. Brain & Development, 23, 42-45.
http://dx.doi.org/10.1016/S0387-7604(00)00197-2
[9] Anlar, B. (2003) Acute Disseminated Encephalomyelitis in Children: Outcome and Prognosis. Neuropediatrics, 34, 194-199. http://dx.doi.org/10.1055/s-2003-42208
[10] Huynh, W, Cordato, D.J. and Kehdi, E. (2008) Post-Vaccination Encephalomyelitis: Literature Review and Illustrative Case. Journal of Clinical Neuroscience, 15, 1315-1322. http://dx.doi.org/10.1016/j.jocn.2008.05.002
[11] Mikaeloff, Y, Caridade, G, Husson, B, et al. (2007) Acute Disseminated Encephalomyelitis Cohort Study: Prognostic Factors for Relapse. European Journal of Paediatric Neurology, 11, 90-95.
http://dx.doi.org/10.1016/j.ejpn.2006.11.007
[12] Dale, R.C, Sousa, C. and Chong, W.K. (2000) Acute Disseminated Encephalomyelitis, Multiphasic Disseminated Encephalomyelitis and Multiple Sclerosis in Children. Brain, 123, 2407-2224.
http://dx.doi.org/10.1093/brain/123.12.2407
[13] Leake, J.A. (2004) Acute Disseminated Encephalomyelitis in Childhood: Epidemiologic, Clinical and Laboratory Features. The Pediatric Infectious Disease Journal, 23, 756-764. http://dx.doi.org/10.1097/01.inf.0000133048.75452.dd
[14] Cohen, O. (2001) Recurrence of Acute Disseminated Encephalomyelitis at the Previously Affected Brain Site. Archives of Neurology, 58, 797-801. http://dx.doi.org/10.1001/archneur.58.5.797
[15] Dale, R.C. and Branson, J.A. (2005) Acute Disseminated Encephalomyelitis or Multiple Sclerosis: Can the Initial Presentation Help in Establishing a Correct Diagnosis. Archives of Disease in Childhood, 90, 636-639.
http://dx.doi.org/10.1136/adc.2004.062935
[16] Dale, R.C. and Pillai, S.C. (2007) Early Relapse Risk after a First CNS Inflammatory Demyelination Episode: Examining International Consensus Definitions. Developmental Medicine & Child Neurology, 49, 887-893.
http://dx.doi.org/10.1111/j.1469-8749.2007.00887.x
[17] Divya, S.K., Mrlvin, J.J. and Sanjeev, V.K. (2005) Acute Disseminated Encephalomyelitis in Children: Discordand Neurologic and Neuroimaging Abnormalities and Response to Plasmapheresis. Pediatrics, 166, 431-436.
[18] Tenembaum, S., Chamoles, N. and Fejerman, N. (2002) Acute Disseminated Encephalomyelitis: A Long-Term Follow-Up Study of 84 Pediatric Patients. Neurology, 22, 1224-1231. http://dx.doi.org/10.1212/WNL.59.8.1224
[19] Kanter, D.S., Horensky, D. and Sperling, R.A. (1995) Plasmapheresis in Fulminant Acute Disseminated Encephalomyelitis. Neurology, 45, 824-827. http://dx.doi.org/10.1212/WNL.45.4.824
[20] Murthy, J.M. (2002) Acute Disseminated Encephalomyelitis. Neurology India, 50, 238-243.
[21] Morimatsu, M. (2004) Recurrent ADEM or MS Internal Medicine, 43, 647-648.
http://dx.doi.org/10.2169/internalmedicine.43.647
[22] Schwaz, S. (2001) Acute Disseminated Encephalomyelitis: A Follow-Up Study of 40 Patients. Neurology, 25, 1383-1318.
[23] Kurtzke, J.F. (1983) Rating Neurological Impairment in Multiple Sclerosis: An Expanded Disability Status Scale (EDSS). Neurology, 3, 1444-1452. http://dx.doi.org/10.1212/WNL.33.11.1444
[24] Polman, C.H., Reingold, S.C., Edan, G., et al. (2005) Diagnostic Criteria for Multiple Sclerosis: 2005 Revisions to the “McDonald Criteria”. Annals of Neurology, 58, 840-846. http://dx.doi.org/10.1002/ana.20703
[25] Kaplan, E.L. and Meier, P. (1958) Nonparametric Estimation from Incomplete Observations. Journal of the American Statistical Association, 53, 457-481. http://dx.doi.org/10.1080/01621459.1958.10501452
[26] Berwick, V., Cheek, L. and Ball, J. (2004) Statistics Review 12: Survival Analysis. Critical Care, 8, 389-394.
http://dx.doi.org/10.1186/cc2955

  
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