Acute disseminated encephalomyelitis medical therapy: Difference between revisions
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* Their role in late presentation of the [[disease]] is still doubtful. | * Their role in late presentation of the [[disease]] is still doubtful. | ||
* Any type of [[vaccination]] should be avoided during the first six months following [[recovery]]. | * Any type of [[vaccination]] should be avoided during the first six months following [[recovery]]. | ||
====[[Plasma exchange]]==== | |||
==References== | ==References== | ||
Revision as of 07:24, 21 November 2022
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Acute disseminated encephalomyelitis Microchapters |
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Differentiating Acute disseminated encephalomyelitis from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Acute disseminated encephalomyelitis medical therapy On the Web |
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Acute disseminated encephalomyelitis medical therapy in the news |
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Directions to Hospitals Treating Acute disseminated encephalomyelitis |
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Risk calculators and risk factors for Acute disseminated encephalomyelitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
The analogy between the pathogenesis of ADEM and MS forms the basis of the use of high-dose steroids, plasma exchange and intravenous immunoglobulin for the treatment of ADEM.
Medical Therapy
Supportive Care[1]
- Airway protection in patients with altered mental status
- Mechanical ventilation in cervical myelitis
- Anti-seizure medications
- Correction of fluid and electrolyte disturbances
- Prophylactic anticoagulation for prevention of deep vein thrombosis in high-risk patients
Immunomodulation
Steroids[1]
- Intravenous methylprednisolone is the first-line drug, leading to full recovery in 50-80% of patients. Concerning disability status, this cohort showed significantly better outcomes than the one treated with dexamethasone[2].
- The dose is 10-30mg/kg/day up to a maximum of 1g/day for 3-5days (Class IV)[3].
- Oral corticosteroids are gradually tapered over six weeks to reduce the risk of relapses.
- Their role in late presentation of the disease is still doubtful.
- Any type of vaccination should be avoided during the first six months following recovery.
Plasma exchange
References
- ↑ 1.0 1.1 Alexander M, Murthy JM (2011). "Acute disseminated encephalomyelitis: Treatment guidelines". Ann Indian Acad Neurol. 14 (Suppl 1): S60–4. doi:10.4103/0972-2327.83095. PMC 3152158. PMID 21847331.
- ↑ Sakakibara R, Hattori T, Yasuda K, Yamanishi T (1996). "Micturitional disturbance in acute disseminated encephalomyelitis (ADEM)". J Auton Nerv Syst. 60 (3): 200–5. doi:10.1016/0165-1838(96)00054-9. PMID 8912271.
- ↑ Straub J, Chofflon M, Delavelle J (1997). "Early high-dose intravenous methylprednisolone in acute disseminated encephalomyelitis: a successful recovery". Neurology. 49 (4): 1145–7. doi:10.1212/wnl.49.4.1145. PMID 9339706.