Relapsing Acute Disseminated Encephalomyelitis in Children: Further Evaluation of the Diagnosis

We examined our cases of relapsing acute disseminated encephalomyelitis (n = 13) in which diagnosis was made before the publication of the International Pediatric Multiple Sclerosis Study Group criteria in 2007, with the aim of reevaluating the primary diagnosis, examining any features indicative of other disorders, and determining the final diagnosis. Mean duration of follow-up was 9.4 (range, 2-20) years. Most (n = 11) were multiphasic, and 2 were recurrent cases. The final diagnosis changed in only 2 patients, both in the multiphasic group: one multiple sclerosis, and one other possible central nervous system vasculitis. All others are still being followed up as relapsing acute disseminated encephalomyelitis and had no further attacks. Six patients in this category did not have encephalopathy at first episode, which suggested the requirement for encephalopathy might be restrictive for certain cases. These results suggest the diagnosis of relapsing acute disseminated encephalomyelitis can be made correctly in most cases by clinical and imaging features.