{"id":3247,"date":"2026-09-04T10:47:45","date_gmt":"2026-09-04T07:47:45","guid":{"rendered":"https:\/\/pediatria-spisanie.eu\/2026\/09\/04\/acute-disseminated-encephalomyelitis-in-childhood-clinical-imaging-and-therapeutic-aspects\/"},"modified":"2026-09-04T17:23:16","modified_gmt":"2026-09-04T14:23:16","slug":"acute-disseminated-encephalomyelitis-in-childhood-clinical-imaging-and-therapeutic-aspects","status":"publish","type":"post","link":"https:\/\/pediatria-spisanie.eu\/en\/2026\/09\/04\/acute-disseminated-encephalomyelitis-in-childhood-clinical-imaging-and-therapeutic-aspects\/","title":{"rendered":"Acute Disseminated Encephalomyelitis in Childhood: Clinical, Imaging, and Therapeutic Aspects"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n\n\t\t<div class=\"icon-box featured-box icon-box-left text-left is-small\"  >\n\t\t\t\t\t<div class=\"icon-box-img\" style=\"width: 20px\">\n\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t<div class=\"icon-inner\" >\n\t\t\t\t\t\t<img decoding=\"async\" width=\"48\" height=\"48\" src=\"https:\/\/pediatria-spisanie.eu\/wp-content\/uploads\/2024\/12\/icons8-user-48.png\" class=\"attachment-medium size-medium\" alt=\"\" \/>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t<div class=\"icon-box-text last-reset\">\n\t\t\t\t\t\t\t\t\t\n\n<p class=\"article-authors\">\n<strong>\nV. Varbanova<sup>1,4<\/sup>, \nG. Tacheva<sup>1,4<\/sup>, \nT. Paneva<sup>1<\/sup>, \nM. Krasteva<sup>1<\/sup>, \nD. Stamatov<sup>1<\/sup>, \nT. Teneva<sup>2,4<\/sup>, \nL. Ilarionova<sup>2,4<\/sup>, \nL. Bozadzhieva<sup>2,4<\/sup>, \nM. Penkov<sup>3,5<\/sup>, \nI. Litvinenko<sup>1,2<\/sup>\n<\/strong>\n<\/p>\n\n<p class=\"article-affiliations\">\n<sup>1<\/sup> Clinic of Pediatric Neurology, Specialized Hospital for Active Treatment of Children\u2019s Diseases \u201cProf. Ivan Mitev\u201d, Sofia<br>\n<sup>2<\/sup> Intensive Care Unit, Specialized Hospital for Active Treatment of Children\u2019s Diseases \u201cProf. Ivan Mitev\u201d, Sofia<br>\n<sup>3<\/sup> University Hospital \u201cSt. Ivan Rilski\u201d EAD, Sofia<br>\n<sup>4<\/sup> Department of Pediatrics, Faculty of Medicine, Medical University \u2013 Sofia<br>\n<sup>5<\/sup> Medical University \u2013 Varna\n<\/p>\n\n\t\t<\/div>\n\t<\/div>\n\t\n\t\n\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Objective:<\/strong>&nbsp;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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Materials and Methods:<\/strong>&nbsp;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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results:<\/strong>&nbsp;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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion:<\/strong>&nbsp;Although acute disseminated encephalomyelitis generally has a favorable outcome, severe and fulminant forms may result in significant long-term sequelae and even death.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Key words<\/strong> <em>acute disseminated encephalomyelitis, multifocal deficit, magnetic resonance imaging (MRI)<\/em><\/p>\n\n\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\t\t<div class=\"wp-block-woocommerce-memberships-member-content\">\n\t\t\t\t\t<div class=\"woocommerce\">\n\t\t\t<div class=\"woocommerce-info wc-memberships-restriction-message wc-memberships-message wc-memberships-content-restricted-message\">\n\t\t\t\tTo access this content, you must purchase <span class=\"wc-memberships-products-grant-access\"><a href=\"https:\/\/pediatria-spisanie.eu\/en\/produkt\/godishen-abonament\/\">\u0413\u043e\u0434\u0438\u0448\u0435\u043d \u0430\u0431\u043e\u043d\u0430\u043c\u0435\u043d\u0442<\/a><\/span>.\t\t    <\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\n\n\n<h2 class=\"wp-block-heading\"><strong>Bibliography<\/strong><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>\u041c\u0438\u043b\u0430\u043d\u043e\u0432 \u0418, \u0422\u0440\u0430\u0439\u043a\u043e\u0432 \u041b, \u0422\u044a\u0440\u043d\u0435\u0432 \u0418, \u0438 \u0434\u0440. \u041d\u0430\u0446\u0438\u043e\u043d\u0430\u043b\u0435\u043d \u043a\u043e\u043d\u0441\u0435\u043d\u0441\u0443\u0441 \u0437\u0430 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u0435 \u043d\u0430 \u043c\u043d\u043e\u0436\u0435\u0441\u0442\u0432\u0435\u043d\u0430 \u0441\u043a\u043b\u0435\u0440\u043e\u0437\u0430. \u0421\u043e\u0444\u0438\u044f: \u0411\u044a\u043b\u0433\u0430\u0440\u0441\u043a\u043e \u0434\u0440\u0443\u0436\u0435\u0441\u0442\u0432\u043e \u043f\u043e \u043d\u0435\u0432\u0440\u043e\u043b\u043e\u0433\u0438\u044f; 2026.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">2. Wang CX. Assessment and Management of Acute Disseminated Encephalomyelitis (ADEM) in the Pediatric Patient.&nbsp;<em>Paediatr Drugs.<\/em>&nbsp;2021;23(3):213-221.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">3. Krupp LB, Tardieu M, Amato MP, et al. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions.&nbsp;<em>Mult Scler.<\/em>&nbsp;2013;19(10):1261-1267.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">4. Clare E. Acute disseminated encephalomyelitis.&nbsp;<em>JAAPA.<\/em>&nbsp;2022;35(9):32-35.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">5. Sun W, Xie Y, Han A, et al. Clinical characteristics and factors associated with recurrence and long-term prognosis in patients with MOGAD.&nbsp;<em>Front Immunol.<\/em>&nbsp;2025;16:1535571.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">6. Berzero G, Cortese A, Ravaglia S, et al. Diagnosis and therapy of acute disseminated encephalomyelitis and its variants.&nbsp;<em>Expert Rev Neurother.<\/em>&nbsp;2016;16(1):83-101.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">7 .Koelman DL, Mateen FJ. Acute disseminated encephalomyelitis: current controversies in diagnosis and outcome.&nbsp;<em>J Neurol.<\/em>&nbsp;2015;262(9):2013-2024.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">8. Neuteboom RF, Boon M, Catsman Berrevoets CE, et al. Prognostic factors after a first attack of inflammatory CNS demyelination in children.&nbsp;<em>Neurology.<\/em>&nbsp;2008;71(13):967-973.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">9. Paolilo RB, Deiva K, Neuteboom R, et al. Acute Disseminated Encephalomyelitis: Current Perspectives.&nbsp;<em>Children (Basel).<\/em>&nbsp;2020;7(11):210.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">10. Koelman DL, Chahin S, Mar SS, et al. Acute disseminated encephalomyelitis in 228 patients: A retrospective, multicenter US study.&nbsp;<em>Neurology.<\/em>&nbsp;2016;86(22):2085-2093.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">11. Wong YYM, van Pelt ED, Ketelslegers IA, et al. Evolution of MRI abnormalities in paediatric acute disseminated encephalomyelitis.&nbsp;<em>Eur J Paediatr Neurol.<\/em>&nbsp;2017;21(2):300-304.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">12. Wells E, Hacohen Y, Waldman A, et al. Neuroimmune disorders of the central nervous system in children in the molecular era.&nbsp;<em>Nat Rev Neurol.<\/em>&nbsp;2018;14(7):433-445.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">13. Pohl D, Alper G, Van Haren K, et al. Acute disseminated encephalomyelitis: Updates on an inflammatory CNS syndrome.&nbsp;<em>Neurology.<\/em>&nbsp;2016;87(9 Suppl 2):S38-S45.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">14. Pohl D, Tenembaum S. Treatment of acute disseminated encephalomyelitis.&nbsp;<em>Curr Treat Options Neurol.<\/em>2012;14(3):264-275.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">15. Alexander M, Murthy JM. Acute disseminated encephalomyelitis: Treatment guidelines.&nbsp;<em>Ann Indian Acad Neurol.<\/em>2011;14(Suppl 1):S60-S64.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">16. Massa S, Fracchiolla A, Neglia C, et al. Update on Acute Disseminated Encephalomyelitis in Children and Adolescents.&nbsp;<em>Children (Basel).<\/em>&nbsp;2021;8(4):280.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">17. Sonneville R, Demeret S, Klein I, et al. Acute disseminated encephalomyelitis in the intensive care unit: clinical features and outcome of 20 adults.&nbsp;<em>Intensive Care Med.<\/em>&nbsp;2008;34(3):528-532.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">18. Absoud M, Parslow RC, Wassmer E, et al. Severe acute disseminated encephalomyelitis: a paediatric intensive care population-based study.&nbsp;<em>Mult Scler.<\/em>&nbsp;2011;17(10):1258-1261.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">19. Burton KLO, Williams TA, Catchpoole SE, et al. Long-Term Neuropsychological Outcomes of Childhood Onset Acute Disseminated Encephalomyelitis (ADEM): a Meta-Analysis.&nbsp;<em>Neuropsychol Rev.<\/em>&nbsp;2017;27(2):124-133.<\/p>\n\n\n<div class=\"is-divider divider clearfix\" ><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Address for correspondence:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Valentina Varbanova<br>Address: 5 Gereno St., Sofia, Bulgaria<br>\u0435mail:&nbsp;<a href=\"mailto:varbanova.valentina98@gmail.com\">varbanova.valentina98@gmail.com<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>V. Varbanova\u00b9\u02d2\u2074, G. Tacheva\u00b9\u02d2\u2074, T. Paneva\u00b9, M. Krasteva\u00b9, D. Stamatov\u00b9, T. Teneva\u00b2\u02d2\u2074, L. Ilarionova\u00b2\u02d2\u2074, L. Bozadzhieva\u00b2\u02d2\u2074, M. Penkov\u00b3\u02d2\u2075, I. Litvinenko\u00b9\u02d2\u00b2 ||| \u00b9 Clinic of Pediatric Neurology, Specialized Hospital for Active Treatment of Children\u2019s Diseases \u201cProf. Ivan Mitev\u201d, Sofia ||| \u00b2 Intensive Care Unit, Specialized Hospital for Active Treatment of Children\u2019s Diseases \u201cProf. Ivan Mitev\u201d, Sofia ||| \u00b3 University Hospital \u201cSt. Ivan Rilski\u201d EAD, Sofia ||| \u2074 Department of Pediatrics, Faculty of Medicine, Medical University \u2013 Sofia ||| \u2075 Medical University \u2013 Varna<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_pediatria_doi":"10.66223\/pediatria.2026.3.006","footnotes":""},"categories":[1301,2684,2679,3399,1],"tags":[1095,3318,3469,3330,3320,3319,3471,3331,2927,2475,2933,2472,2470,3323,2928,3326,3474,3329,3322,3327,3321,3328,1114,3324],"class_list":["post-3247","post","type-post","status-publish","format-standard","hentry","category-articles","category-issue-3-2026","category-broj-3-2026","category-statii","tag-1095","tag-acute-disseminated-encephalomyelitis-in-childhood-clinical","tag-although-acute-disseminated-encephalomyelitis-generally-has-a-favorable-outcome","tag-and-therapeutic-aspects","tag-imaging","tag-severe-and-fulminant-forms-may-result-in-significant-long-term-sequelae-and-even-death","tag-v-varbanova1","tag-g-tacheva1","tag-d-stamatov1","tag-i-litvinenko1","tag-l-bozadzhieva2","tag-l-ilarionova2","tag-m-krasteva1","tag-m-penkov3","tag-magnitno-rezonansna-tomografiya","tag-obrazni-i-terapevtichni-aspekti","tag-ostar-diseminiran-enczefalomielit","tag-ostar-diseminiran-enczefalomielit-v-detska-vazrast-klinichni","tag-polifokalen-deficzit","tag-t-paneva1","tag-t-teneva2"],"_links":{"self":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/3247","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/comments?post=3247"}],"version-history":[{"count":3,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/3247\/revisions"}],"predecessor-version":[{"id":3255,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/3247\/revisions\/3255"}],"wp:attachment":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/media?parent=3247"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/categories?post=3247"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/tags?post=3247"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}