13例急性播散性脑脊髓炎临床分析

目的 探讨急性播散性脑脊髓炎（ADEM）的临床特点，提高对其诊治水平。方法 通过对13例临床诊断为急性播散性脑脊髓炎的患儿进行回顾性分析，探讨该病的临床特点、治疗及预后。结果 11例（84.6％，11／13）病前有急性感染或疫苗接种史，9例（69．2％，9／13）头颅MRI显示白质异常；确诊后10例患儿应用甲基强的松龙治疗，6例同时合并应用大剂量人血丙种球蛋白（IVIG），1例死亡，其余12例均有不同程度的好转。12例随访6月～7年，均无复发，7例（58．3％，7／12）留有神经系统后遗症。结论 急性播散性脑脊髓炎（ADEM）致残率较高．应及早诊治：糖皮质激素和大剂量丙球对该病有一定疗效。

Clinical analysis of acute disseminated encephalomyelitis in 13 children

Objective To discuss the clinical features of acute disseminated encephalomyelitis (ADEM) in children and to improve the skill of diagnosis and therapy. Methods A retrospective analyses and study up on 13 children with the clinical diagnosis of ADEM to identify the clinical features, treatment and prognosis. Results The prodromal infection and vaccination were in 84.6% (11/13). 69.2% (9/13) MRI brain scan demonstrated lesions predominantly effecting white matter. High dose methylprednisolone was administered in 10 cases, at the sane time, 6 cases of them received intravenous immunoglobulin. One of them was died, The other 12 cases various degrees showed good response. 12 cases were taken follow-up from 6 months to 7 years. No recurrence occurred in all the cases. 58.3% (7/13) of them had long-term neural sequelae. Conclusions Acute disseminated encephalomyelitis (ADEM) is a disease with high incidence of disability. Early diagnosis and treatment are important. Steroid and high dose immunoglobulin have great effects on it.