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Gepubliceerd in: Tijdschrift voor Kindergeneeskunde 2/2002

01-10-2002 | Artikelen

Acute gedissemineerde encefalomyelitis (adem) op de kinderleeftijd: klinisch spectrum en therapie

Auteurs: J. H. L. van den Aker, A. Verrips, M. A. A. P. Willemsen, J. J. Rotteveel

Gepubliceerd in: Tijdschrift voor Kindergeneeskunde | Uitgave 2/2002

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Samenvatting

adem is een immunologische, demyeliniserende aandoening van het centraal zenuwstelsel, die vooral op de kinderleeftijd optreedt. Het ziektebeeld wordt vaak gezien in aansluiting op een (virale) infectie of vaccinatie en heeft in principe een monofasisch beloop. Ter illustratie van de grote verschillen in neurologische symptomatologie en klinisch beloop bij adem, beschrijven we drie kinderen met deze aandoening. De klinische manifestatie begint vaak acuut met een encefalopatisch beeld met koorts en hoofdpijn, gepaard gaande met multifocale neurologische uitvalsverschijnselen. Voor het stellen van de diagnose is beeldvorming met mri essentieel. Vroegtijdige, hooggedoseerde corticosteroïdbehandeling lijkt de meest effectieve therapie, waarbij er geen consensus is over de optimale dosis en behandelingsduur. Bij onvoldoende effect van corticosteroïden worden plasmaferese- of immunoglobulinetoediening toegepast. Ook deze therapieën zijn gebaseerd op casuïstiek en niet-gecontroleerde studies. Hoewel adem in de acute fase fulminant kan verlopen met coma, convulsies en overlijden, is de langetermijnprognose meestal goed.
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Metagegevens
Titel
Acute gedissemineerde encefalomyelitis (adem) op de kinderleeftijd: klinisch spectrum en therapie
Auteurs
J. H. L. van den Aker
A. Verrips
M. A. A. P. Willemsen
J. J. Rotteveel
Publicatiedatum
01-10-2002
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Kindergeneeskunde / Uitgave 2/2002
Print ISSN: 0376-7442
Elektronisch ISSN: 1875-6840
DOI
https://doi.org/10.1007/BF03061408

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