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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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