Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

Lee, Yun Jin

Until 2006, the Poser criteria were considered the most useful in making a diagnosis of pediatric MS 24) . In 2007, the Pediatric Multiple Sclerosis Study Group proposed new working definitions for pediatric MS and related demyelinating diseases such as ADEM 23) . Dissemination in space, demonstrated by: ≥9 T2 lesions in the brain or 2 or more lesions in the spinal cord or 4 to 8 brain plus 1 spinal cord lesion or abnormal visual evoked potential (delay with a well preserved wave form, typical of MS) associated with 4 to 8 brain lesions or with fewer than 4 brain lesions plus 1 spinal cord lesion demonstrated by MRI and Dissemination in time, demonstrated by: MRI †or continued progression for 1 year MRI, magnetic resonance imaging; CSF, cerebrospinal fluid; MS, multiple sclerosis. *MRI criteria include 3 or 4 of the following: 1 gadolinium enhancing lesion or 9 T2 hyperintense lesions if there is no gadolinium enhancing lesion; at least 1 infratentorial lesion; at least 1 juxtacortical lesion; at least 3 periventricular lesions; 1 spinal cord lesion can be substituted for 1 brain lesion. †For MRI dissemination in time criteria, see Table 3 .