Diagnosis and treatment of 12 cases of acute disseminated encephalomyelitis and polyneuropathies

Abstract

Objective To analyze the diagnosis and treatment of 12 patients with acute disseminated encephalomyelitis and polyneuropathies (ADEMP), so as to improve the clinical knowledge of the disease. Methods Twelve patients with ADEMP were selected from Yanzhou Hospital, Affiliated Hospital of Jining Medical College from February 2014 to February 2018 by the method of stratified cluster sampling and retrospective analysis. The detailed data of diagnosis and treatment were retrospectively analyzed. Results Twelve ADEMP patients had high fever, nausea and vomiting, headache, delirium and convulsions. Most patients had a history of infection or vaccination, some leisons involved cranial nerves, some patients showed symmetrical limb retardation or paraplegia, with or without respiratory muscle paralysis or respiratory failure, urinary and fecal disorders, sensory disorder. Blood routine examination showed a slight increase in white blood cell count; cerebrospinal fluid examination showed a slight and moderate increase in protein and white blood cell count. Electroencephalogram showed mild and moderate abnormalities; electromyogram examination showed common motor nerve axonal injury. Early magnetic resonance imaging showed no obvious abnormalities; after 1 to 2 weeks of illness, multiple diffuse abnormal signals could be seen in the brain and spinal cord. After treatment and nursing with glucocorticoid combined with immunoglobulin, one patient died of severe complications; the other 11 patients were followed up for one year, and 1 case was found with recurrence, 1 case had visual impairment and 1 case had cognitive impairment. The multiple prognoses of most of them were good. Conclusions ADEMP is accompanied by the clinical characteristics of acute disseminated encephalomyelitis and acute inflammatory demyelinating polyneuropathy. Since there is no obvious abnormality in the early megnetic resonance imaging examination, and the rate of misdiagnosis and missed diagnosis of the disease is high, it should be jointly diagnosed with other auxiliary methods. Patients should be treated with glucocorticoid or combined immunoglobulin, which is effective and has good prognosis, by which most of the lesions are absorbed within 1 to 3 months. Key words: Acute disseminated encephalomyelitis; Nerve root neuritis; Diagnosis and treatment analysis