Affiliations: Departments of Pediatrics at King Hussein Medical
Center, Amman, Jordan | Princess Rahmah Teaching Hospital and King Abdullah
University Hospital, Irbid, Jordan
Note: [] Correspondence: Azhar Daoud, MD, Professor of Child Neurology,
King Abdullah University Hospital, Jordan University of Science and Technology,
P.O. Box 2227, Irbid 21110, Jordan. Tel.: +962 79 5600420; Fax: +962 6 5515598;
E-mail: daoud@just.edu.jo
Abstract: Our purpose is to describe the clinical, neuroradiologic features
and outcome of patients with acute encephalomyelitis (ADEM) from Jordan, a
developing country, and to compare the findings to other reports from the
developed and developing countries. A retrospective review was conducted of the
medical records and magnetic resonance imaging (MRI) findings of children who
presented to any of the three hospitals that were involved in the study in
Jordan from 2002 to 2005. Eleven children were diagnosed with ADEM by clinical
and MRI findings. All were treated with steroids and evaluated at 6–24 month
follow-up. Three of the children (27% presented with a history of recent
upper respiratory tract infection, but none presented with a recent history of
vaccination. Prodromal signs and symptoms were reported in only six (55% of the
children. All the children except one had a motor deficit. Only three (27%
of the children had abnormal cerebrospinal fluid (CSF) findings and eight had
normal results. MRI lesions were most commonly bilateral and asymmetric but
varied in shape and size. The use of methylprednisolone was usually associated
with reasonable recovery. Nine patients (82%) recovered completely while two
children recovered with sequelae. Compared to reports from developed countries,
this series has a lower prevalence of preceding non-specific infection and a
higher prevalence of normal CSF findings. These findings may be related to a
difference in etiologic pathogens. Therefore, a larger regional multicenter
study is highly recommended.
