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首页> 外文期刊>European journal of paediatric neurology: EJPN : official journal of the European Paediatric Neurology Society >Acute disseminated encephalomyelitis cohort study: Prognostic factors for relapse.
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Acute disseminated encephalomyelitis cohort study: Prognostic factors for relapse.

机译：急性弥漫性脑脊髓炎队列研究：复发的预后因素。

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摘要

To date, there is no available epidemiological study about prognostic factors of acute disseminated encephalomyelitis (ADEM) in children, using a cohort of patients with homogenous inclusion criteria. We aimed to evaluate prognostic factors for relapse after ADEM in children. A total of 132 children from the French National KIDSEP Neuropediatric Cohort (mean age at onset: 6+/-3.3 years; mean follow-up: 5.4+/-3.3 years; lost to follow-up: 10%). ADEM diagnosis was considered in a previously healthy patient acutely presenting more than one neurological deficit, change in mental state and MRI alterations including white matter changes. We used multivariate survival analysis (Cox model) evaluating the prognostic value of baseline clinical, biological and MRI covariates, for the occurrence of a second attack. Twenty-four (18%) of included patients had a second attack. An increased risk of relapse was associated with optic neuritis (hazard ratio, 5.23; 95% CI, 2-13.65), familial history of central nervous system inflammatory demyelination (7.79; 1.54-39.5), Barkhof multiple sclerosis (MS) criteria on MRI (2.52; 1.04-6.12) and no neurological sequelae after first attack (3.79; 1.12-12.85). Clinical and MRI prognostic factors for relapse in ADEM may contribute to an early distinction between monophasic and relapsing disease, which may be related to MS.
机译：迄今为止，尚无可用的采用均一纳入标准的患者队列研究儿童急性播散性脑脊髓炎（ADEM）预后因素的流行病学研究。我们旨在评估儿童ADEM复发的预后因素。来自法国国家KIDSEP神经小儿队列的132名儿童（平均发病年龄：6 +/- 3.3岁;平均随访：5.4 +/- 3.3岁;失去随访：10％）。在先前健康的患者中考虑了ADEM诊断，该患者急性出现多个神经功能缺损，精神状态改变和MRI改变（包括白质改变）。我们使用多元生存分析（Cox模型）评估基线临床，生物学和MRI协变量对第二次发作的预后价值。纳入的患者中有二十四名（18％）有第二次发作。复发风险增加与视神经炎（危险比5.23; 95％CI 2-13.65），家族性中枢神经系统炎性脱髓鞘病史（7.79; 1.54-39.5），Barkhof多发性硬化（MS）的MRI标准有关（2.52; 1.04-6.12），第一次发作后没有神经系统后遗症（3.79; 1.12-12.85）。 ADEM复发的临床和MRI预后因素可能有助于早期区分单相性和复发性疾病，这可能与MS有关。

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