Walsh & Hoyt: Treatment

Update Item Information
Identifier wh_ch60_p3511_1
Title Walsh & Hoyt: Treatment
Creator Laura J. Balcer, MD
Affiliation Professor, Department of Neurology, NYU Langone
Subject Demyelinating Diseases; Acute Disseminated Encephalomyelitis; Adem; Postinfections Encephalomyelitis; Treatment
Description The treatment of patients with ADEM is primarily supportive. Control of fever and seizures, reduction of increased ICP by medical or surgical methods, and prolonged assisted ventilation may be necessary. Hyperimmune gamma globulin is of no benefit. Systemic corticosteroids are given to some patients in an effort to reduce both the severity and duration of neurologic dysfunction; however, both nonrandomized and randomized studies show no modification of the clinical course or recovery, and one retrospective study of patients with ADEM found a higher mortality and morbidity among patients who received systemic corticosteroids. Because more severely affected patients would be those most likely to receive corticosteroids, these data were reanalyzed, including only patients admitted in coma. Even then, death rates were higher among patients treated with systemic corticosteroids. If ADEM is the closest clinical correlate to experimental allergic encephalomyelitis, then lessons from the laboratory would suggest avoiding abrupt withdrawal of steroid therapy. Plasmapheresis and treatment with IV-Ig may be beneficial in the treatment of ADEM, but no large series confirms their efficacy. With aggressive supportive therapy, even patients who experience long periods of coma eventually may recover with little or no neurologic sequelae.
Date 2005
Language eng
Format application/pdf
Type Text
Relation is Part of Walsh and Hoyt's Clinical Neuro-Ophthalmology Walsh and Hoyt's Clinical Neuro-Ophthalmology
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Wolters Kluwer Health, Philadelphia
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890
Rights Management Copyright 2005. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6vq6b4q
Setname ehsl_novel_whts
ID 186333
Reference URL https://collections.lib.utah.edu/ark:/87278/s6vq6b4q