What Is the Relapse Risk in Acute Disseminated Encephalomyelitis?

Acute disseminated encephalomyelitis (ADEM) usually is a monophasic demyelinating disorder, predominantly observed in children. To assess actual outcomes in a large U.S. cohort, researchers retrospectively analyzed data from four U.S.-based pediatric multiple sclerosis (MS) centers. The analysis included 228 patients (47% male; 122 children; age range, 1–72) initially diagnosed with ADEM and followed for a median 24 months (range, 0–277).

International Pediatric MS Study Group criteria were met in 70% of pediatric cases and 47% of adult cases; not meeting the criteria was most often due to absence of encephalopathy. Most patients (58%) had infectious symptoms or vaccination within 4 weeks before presentation. The disease course was monophasi…