Articles, Issue 3/2026, Брой 3/2026, Брой 3/2026, Articles

Acute Disseminated Encephalomyelitis in Childhood: Clinical, Imaging, and Therapeutic Aspects

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DOI: 10.66223/pediatria.2026.3.006

V. Varbanova1,4, G. Tacheva1,4, T. Paneva1, M. Krasteva1, D. Stamatov1, T. Teneva2,4, L. Ilarionova2,4, L. Bozadzhieva2,4, M. Penkov3,5, I. Litvinenko1,2

1 Clinic of Pediatric Neurology, Specialized Hospital for Active Treatment of Children’s Diseases “Prof. Ivan Mitev”, Sofia
2 Intensive Care Unit, Specialized Hospital for Active Treatment of Children’s Diseases “Prof. Ivan Mitev”, Sofia
3 University Hospital “St. Ivan Rilski” EAD, Sofia
4 Department of Pediatrics, Faculty of Medicine, Medical University – Sofia
5 Medical University – Varna

Abstract

Acute disseminated encephalomyelitis is a rare post-infectious demyelinating disorder of the central nervous system, predominantly affecting children. It is characterized by acute onset, encephalopathy, multifocal neurological deficits, and characteristic magnetic resonance imaging findings.

Objective: The aim of this study was to evaluate the clinical course, neuroimaging findings, treatment strategies, and outcomes in a Bulgarian pediatric cohort with acute disseminated encephalomyelitis.

Materials and Methods: A retrospective single-center study was conducted over a 10-year period and included six children diagnosed with acute disseminated encephalomyelitis. Clinical, neuroimaging, and electrophysiological data, as well as treatment outcomes and prognosis, were analyzed.

Results: The mean age at disease onset was 5.08 years. Encephalopathy was the most common clinical manifestation, followed by central paresis and epileptic seizures. Magnetic resonance imaging revealed multiple asymmetric demyelinating lesions. One patient developed acute hemorrhagic encephalomyelitis. Complete clinical recovery was observed in four patients.

Conclusion: Although acute disseminated encephalomyelitis generally has a favorable outcome, severe and fulminant forms may result in significant long-term sequelae and even death.

Key words acute disseminated encephalomyelitis, multifocal deficit, magnetic resonance imaging (MRI)

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Address for correspondence:

Valentina Varbanova
Address: 5 Gereno St., Sofia, Bulgaria
еmail: varbanova.valentina98@gmail.com