Clinical and imaging features of 15 elderly patients with acute disseminated encephalomyelitis

TAN Xiaomu; LIU Jianguo; AN Li; XIE Rui; ZHANG Fengqun; HUANG Xin

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Medical Journal of the Chinese People Armed Police Forces ›› 2021, Vol. 32 ›› Issue (4) : 309-315.

ORIGINAL ARTICLES

Clinical and imaging features of 15 elderly patients with acute disseminated encephalomyelitis

TAN Xiaomu¹, LIU Jianguo², AN Li³, XIE Rui³, ZHANG Fengqun³, HUANG Xin¹

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Abstract

Objective To investigate the clinical and imaging characteristics of acute disseminated encephalomyelitis (ADEM) among elderly patients.Methods The clinical, laboratory and image data of fifteen elderly ADEM patients hospitalized between March 2013 and January 2019 was retrospectively analyzed.Results A total of 15 patients aged 60 to 77 were enrolled. Five of them had an acute onset and 10 a subacute onset. Among them, 2 cases had prodromal inducement. The first symptoms included headache (4 cases), hemiplegia (4 cases), paraplegia (2 cases), right facial twitch (1 case), diplopia (1 case), somnolence (1 case), abdominal pain (1 case) and visual disturbance (1 case). Head MR imaging showed lesions in 13 cases, and there was no significant difference in imaging manifestations between these elderly ADEM patients and children, middle-aged and young ADEM patients reported in the literature, but 2 cases in our study had tumefactive demyelinating lesions. Abnormal nerve conductive velocity was found in 4/6 cases, suggesting that the incidence of peripheral nerve damage in our study was higher than what was reported about younger ADEM patients in previous literature. At the end of follow-up, 8 patients were still suffering from moderate or severe neurological dysfunction or died, indicating that the prognosis was worse than what was reported about younger ADEM patients in previous literature.Conclusions Elderly patients with ADEM are characterized by fewer prodromal symptoms, milder onset, more atypical first symptoms, and more peripheral nerve involvement. They are prone to misdiagnosis and have relatively poor clinical prognosis.

Key words

acute disseminated encephalomyelitis / tumefactive demyelinating lesions / magnetic resonance / prognosis

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TAN Xiaomu, LIU Jianguo, AN Li, XIE Rui, ZHANG Fengqun, HUANG Xin. Clinical and imaging features of 15 elderly patients with acute disseminated encephalomyelitis[J]. Medical Journal of the Chinese People Armed Police Forces. 2021, 32(4): 309-315

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