Effectiveness of intravenous immunoglobulin treatment in adult patients with steroid-resistant monophasic or recurrent acute disseminated encephalomyelitis

E. Marchioni, K. Marinou-Aktipi, C. Uggetti, M. Bottanelli, A. Pichiecchio, D. Soragna, G. Piccolo, F. Imbesi, A. Romani, M. Ceroni

Research output: Contribution to journalArticle

Abstract

Randomized Controlled Trials have not jet established the best pharmacological management of Acute Disseminated Encephalomyelitis (ADEM). High dose steroids are usually employed with good results, but in a few cases the clinical outcome is poor. In other patients, particularly those affected by the site restricted ADEM variants (myelitis), the disease shows a recurrent course resembling that of Multiple Sclerosis. We present here five patients, 3 of them affected by classic disseminated encephalomyelitis and 2 by a post infectious myelitis, which showed a good response to intravenous immunoglobulin (IVIg) after steroid treatment failure. In our report high dose steroids administration was substantially uneffective in all but one case, who showed a good response only during the first episode. On the contrary IVIg injection (0,4 gr/kg/day) produced a marked functional improvement in all patients starting within the first five days of drug administration and reaching a maximum within three weeks. One patient experienced a good effect nothwithstanding a steady dysability. In all cases, clinical evidence was supported by MRI controls showing improving posttreatment changes.

Original languageEnglish
Pages (from-to)100-104
Number of pages5
JournalJournal of Neurology
Volume249
Issue number1
Publication statusPublished - 2002

    Fingerprint

Keywords

  • Acute disseminated encephalomyelitis
  • IVIg
  • Scripps Neurological Scale
  • Steroids
  • Variant

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this