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Of the 31 patients included in this study, 22 (71%) experienced a prodromal illness. Two patients (6%) had received hepatitis B vaccine 3 to 6 weeks before developing their illness. Symptoms and signs typically evolved over several days. Ataxia was the most common presenting feature, occurring in 20 patients (65%). MRI findings were variable, but lesions were most commonly seen bilaterally and asymmetrically in the frontal and parietal lobes. The authors found a high incidence of the co rpus callosal and periventricular changes more typically associated with MS, but they also found a high rate of deep gray matter involvement (61% of patients). The use of high-dose IV methylprednisolone was usually associated with rapid recovery. Eighty -one percent of patients recovered completely, with only mild sequelae recorded in the remaining children. In the absence of a biological marker, the distinction between ADEM and MS cannot be made with certainty at the time of first presentation, but the authors suggest that a viral prodrome, early-onset ataxia, high lesion load on MRI, involvement of the deep gray matter, and absence of oligoclonal bands are more indicative of ADEM. |
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acute disseminated encephalomyelitis ataxia cerebrospinal fluid,oligoclonal IgG in children gray matter misdiagnosis MRI MRI,abnormal MRI,disappearing lesion on MRI,volumetry multiple sclerosis multiple sclerosis,differential diagnosis of multiple sclerosis,misdiagnosis neurologic disease,diagnoses of prognosis review article steroid steroid therapy,CNS treatment and complications with treatment of neurologic disorder viral infection
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