The Turkish Journal of Pediatrics 2020 , Vol 62 , Num 4
Neuropsychological outcome in cases with acute disseminated encephalomyelitis
Seda Kanmaz 1 ,Sezen Köse 2 ,Cenk Eraslan 3 ,Erdem Şimşek 1 ,Hepsen Mine Serin 1 ,Sanem Yılmaz 1 ,Gül Aktan 1 ,Hasan Tekgül 1 ,Hatice Serpil Erermiş 2 ,Sarenur Gökben 1
1 Division of Child Neurology, Ege University Faculty of Medicine, İzmir, Turkey
2 Department of Pediatrics, Child and Adolescent Psychiatry, Ege University Faculty of Medicine, İzmir, Turkey
3 Department of Pediatrics, Neuroradiology, Ege University Faculty of Medicine, İzmir, Turkey.
DOI : 10.24953/turkjped.2020.04.009 Background and objectives. Acute disseminated encephalomyelitis (ADEM) is an immune-mediated, inflammatory and demyelinating disorder of the central nervous system. There have been a few studies in recent years on the fact that these cases have neurocognitive impairment. The purpose of this study is to evaluate the neurocognitive outcome and quality of life in cases with ADEM.

Methods. Eleven cases who were on follow-up between 2008 and 2017 were included in the study, systemic, neurological and psychiatric examinations were done. All magnetic resonance images were re-evaluated. The neuropsychiatric evaluation was performed by clinical examination and psychometric scales; (1) The Pediatric Quality of Life Inventory 4.0, (2) Child Behavior Checklist, (3) Children`s Depression Inventory, (4) The Wechsler Intelligence Scale for Children-Revised and (5) Continuous Performance Test. The cases in our study underwent neuropsychiatric evaluation 3-42 months after the diagnosis of ADEM had been established.

Results. Nine cases (81.8%) fully recovered without neurologic deficit. One case (9.1%) had a psychiatric disorder. During follow-up, cognitive and psychiatric problems were encountered in half of the cases (54.5%). Most of the cases with basal ganglia involvement (80%) displayed attention deficit and cognitive problems.

Conclusion. In particular, cases with basal ganglia involvement should be followed carefully in terms of attention and cognitive problems. Keywords : ADEM, neuroimaging, neuropsychiatric disorders

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