Prediction of Transformation of Acute Disseminated Encephalomyelitis into Multiple Sclerosis

Abstract

Prediction of transformation of acute disseminated encephalomyelitis (ADEM) into multiple sclerosis is of great clinical importance, as it enables timely determination of the tactics for treatment of a patient as well as volume of respective therapeutic interventions.This work is aimed at ascertainingthe prognostic factors that determine the risk of transformation of acute disseminatedencephalomyelitis into multiple sclerosis. We have examined 101 patients with the diagnosis ADEM, namely: 28 men and 73 women in the age from 17 up to 53 years (average value31.7 ± 1.01years). To ascertain the prognostic meaning of clinic-paraclinic indices corresponding to patients with ADEM, we estimated the cumulative part of absence of relapses in the group of patients by using the Kaplan-Meyer method with estimating the Fisher criterion and using the most important clinic-paraclinic data. Development of transformation of ADEM into multiple sclerosis is reliably related to the following prognostic signs: degree of disability in accord with the EDSS scale and sizes of demyelination focuses determined using MRT. Criteria for congenial prediction in disease development with delayed appearance of transformation of ADEM into multiple sclerosis are as follows: slight degree (in EDSS scale) of disability and large sizes of demyelination focuses (MRT data).Our analysis of the main clinic-paraclinic indexes obtained using the Kaplan-Meyer method indicates reliability of results and enables us to find a number of important prognostic criteria for development of transformation of ADEM into multiple sclerosis.