Aim: Acute disseminated encephalomyelitis (ADEM), also known as postinfectious encephalomyelitis, is a demyelinating disease of the central nervous system typically associated with multifocal neurological symptoms and encephalopathy. High-dose intravenous corticosteroids, intravenous immunoglobulin, and therapeutic plasma exchange are used in the treatment, and more studies are still needed for optimal treatment.
Material and Method: Our patient, who was followed up in our pediatric intensive care unit and diagnosed with ADEM, was included in the study. Bakırkoy Dr. Sadi Konuk Training and Research Hospital Ethics Committee Approval were obtained.
Results: A 3.5-year-old, unvaccinated male patient had upper respiratory tract infection symptoms 10 days before his admission. He had complaints of fever, meningismus, altered consciousness, the inward shift in the left eye, and inability to walk. After the diagnosis of ADEM was made with the imaging of our patient, therapeutic plasma exchange was performed daily (TPE) for 7 days. On the 5th day of TPE, his muscle strength was 4/5 and he started walking with physical therapy support on the 7th day; In the control craniospinal MRI imaging of the patient whose gaze restriction did not disappear, on the 15th day of treatment, T2W sequences were normal and significant regression was observed in the findings.
Conclusion: Although there is limited data, TPE is thought to be beneficial in children with ADEM who show poor response to intravenous immunoglobulin (IVIG) and/or methylprednisolone treatment as the recommended immunotherapy, and a clinical response was observed in our patient after TPE application.
Key words: Acute disseminated encephalomyelitis, childhood, MRI
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