Prediction of Transformation of Acute Disseminated Encephalomyelitis into Multiple Sclerosis


Prediction of transformation of acute disseminated encephalomyelitis (ADEM) into multiple sclerosis is of great clinical importance, as it enables timely determination of the tactics for treatment of a patient as well as volume of respective therapeutic interventions.This work is aimed at ascertainingthe prognostic factors that determine the risk of transformation of acute disseminatedencephalomyelitis into multiple sclerosis. 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 value31.7 ± 1.01years). 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 transformation of ADEM into multiple sclerosis is reliably related to the following prognostic signs: degree of disability in accord with the EDSS scale and sizes of demyelination focuses determined using MRT. Criteria for congenial prediction in disease development with delayed appearance of transformation of ADEM into multiple sclerosis are as follows: slight degree (in EDSS scale) of disability and large sizes of demyelination focuses (MRT data).Our analysis of the main clinic-paraclinic indexes obtained using the Kaplan-Meyer method indicates reliability of results and enables us to find a number of important prognostic criteria for development of transformation of ADEM into multiple sclerosis.

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Myalovitska, O. , Lobanova, I. and Kobys, T. (2014) Prediction of Transformation of Acute Disseminated Encephalomyelitis into Multiple Sclerosis. International Journal of Clinical Medicine, 5, 433-439. doi: 10.4236/ijcm.2014.58059.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Tenembaum, S. (2008) Disseminated Encephalomyelitis in Children. Clinical Neurology and Neurosurgery, 110, 928-938.
[2] Brass, S.D. (2003) Multiple Sclerosis and Acute Disseminated Encephalomyelitis in Childhood. Pediatric Neurology, 29, 227-231.
[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.
[6] Toshiyuki, O. and Shunsaku, H. (2004) Reccurence of Acute Disseminated Encephalomyelitis after a 12-Year Symptom-Free Interval. Interval Medicine, 43, 746-749.
[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 and Development, 23, 42-45.
[9] Anlar, B. (2003) Acute Disseminated Encephalomyelitis in Children: Outcome and Prognosis. Neuropediatrics, 34, 194-199.
[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.
[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.
[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.
[13] Leake, J.A. (2004) Acute Disseminated Encephalomyelitis in Childhood: Epidemiologic, Clinical and Laboratory Features. The Pediatric Infectious Disease Journal, 23, 756-764.
[14] Cohen, O. (2001) Recurrence of Acute Disseminated Encephalomyelitis at the Previously Affected Brain Site. Archives of Neurology, 58, 797-801.
[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.
[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.
[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.
[19] Kanter, D.S., Horensky, D. and Sperling, R.A. (1995) Plasmapheresis in Fulminant Acute Disseminated Encephalomyelitis. Neurology, 45, 824-827.
[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.
[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 Staty Scale (EDSS). Neurology, 3, 1444-1452.
[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.
[25] Kaplan, E.L. and Meier, P. (1958) Nonparametric Estimation from Incomplete Observations. Journal of the American Statistical Association, 53, 457-481.
[26] Berwick, V., Cheek, L. and Ball, J. (2004) Statistics Review 12: Survival Analysis. Critical Care, 8, 389-394.

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