The Epidemiologic and Demographic Characteristics and Clinical Findings in Patients with Acute Disseminated Encephalomyelitis (ADEM) Referred to Alzahra Hospital, Isfahan, Iran, During 10 Years (2003-2013)

Background: Acute disseminated encephalomyelitis (ADEM) is an uncommon monophasic disease often with good prognosis. It is a differential diagnosis of multiple sclerosis (MS). Accurate distinction between acute disseminated encephalomyelitis and multiple sclerosis is important for prognosis and treatment; as many patients with multiple sclerosis may benefit from early disease-modifying therapy to suppress ongoing and future relapses. Methods: In a retrograde study, all the patients presented to Alzahra hospital (Isfahan, Iran) with definite diagnosis of acute disseminated encephalomyelitis during a 10-year period were included. Demographic data, clinical signs and symptoms, and laboratory and imaging findings were collected and analyzed using t and chi-square tests via SPSS software. Findings: Forty-two patients with mean age of 20.05 ± 10.04 years and a female-predominance of 64.3% participated in the study. Thirty-three patients (78.6%) had a recent history of infectious disease. A seasonal pattern of distribution in spring (31%) and autumn (31%) was seen. The cerebrospinal fluid (CSF) analysis findings showed pleocytosis and increased protein in 26 (61.9%) and 25 (59.6%) cases, respectively. First magnetic resonance imaging (MRI) findings revealed that most of the lesions were in the periventricular (83%) and re-imaging in 25 cases showed completely or partially resolution of previous lesions with no new lesion in 18 (72%) and 7 (28%) patients, respectively. Conclusion: We found some controversies to previous studies in epidemiological and imaging studies which could be of a significant role in detecting and accurate diagnosis of acute disseminated encephalomyelitis which can significantly impact on physicians’ view of the disease.