Analysis of Prognostic Significance of Clinical and Paraclinical Indices in Case of Different Types of Acute Disseminated Encephalomyelitis Course

Abstract

In most casesacute disseminated encephalomyelitis (ADEM) is characterized by monophasic course, but occurring relapses of the disease can be interpreted as multiphasic course of acute disseminated encephalomyelitis or its transformation into multiple sclerosis (MS). This work is aimedat assessing the clinical/ paraclinical predictors of relapses and transformation to MS in patients presenting with ADEM/MDEM. We have examined 101 patients with the diagnosis ADEM, namely: 28 men and 73 women aged 17 - 53 (average age value 31.7±1.01). Comparison groups included patients with monophasic and multiphasic types of acuted is seminated encephalomyelitis evolved to MS. The investigated clinical and paraclinical parameters included: the number of points according to EDSS scale,number of demyelination foci and their diameter, the presence of perifocal edema. In case of multiphasic type of course of the disease and its transformation into multiple sclerosis, an increase in the number of points on the EDSS as well as in number of demyelination foci, and decrease of foci diameter and perifocal edema (more pronounced in case of the transformation into multiple sclerosis) were observed. Thus, all the investigated clinical and paraclinical indices andtheir changes during the period of observation have prognostic significance for assessment of the type of ADEM course (monophasic, multiphasic and transformation in multiple sclerosis).