Pakistan Armed Forces Medical Journal (Oct 2018)
FUCTIONAL OUTCOME OF ACUTE DISSEMINATED ENCEPHALOMYELITIS IN CHILDREN
Abstract
Objective: To determine functional outcome of acute disseminated encephalomyelitis in children and factors affecting outcome at The Children’s Hospital, Lahore. Study Design: Cross-sectional observational study. Place and Duration of Study: Department of Pediatric Neurology, The Children’s Hospital and Institute of Child Health, Lahore from Nov 2014 to Oct 2015. Material and Methods: Fifteen patients with acute disseminated encephalomyelitis fulfilling the inclusion criteria were enrolled. Detailed history, examination, prior febrile illness and modified Rankin scale score for functional disability at presentation and discharge were recorded through study proforma. All patients underwent lumbar puncture and neuroimaging. Data were analysed in SPSS (v.20) and Chi-square test was applied to find p-value. Results: Out of 15 patients, there was male predominance (10 male 66.7%) with mean age 7.4 ± 2.5 years. Encephalopathy 100% (n=15) followed by fever, fits 73.3% (n=11) and motor deficit 60% (n=9) were common presentation. About 46.7% (n=7) cases had prior febrile illness. MRI brain had >5 lesions in 86.7% (n=13) with sub-cortical area 93.3% (n=14) periventricular area 86.7% (n=13). Functional outcome was good in 80% (modified Rankin scale of 2 or less at time of discharge). Consciousness level and disability score at presentation were statistically significant factors affecting the outcome (p-value 0.004 & 0.002 respectively). Conclusion: Acute disseminated encephalomyelitis in children had variable clinical presentation. It has good outcome with level of consciousness and disability score being significant factors affecting outcome.
