Relapse Factors of Acute Central Nervous System Inflammatory Demyelinating Disease in Children / 实用儿科临床杂志

ABSTRACT

Objective To explore influential factors and features of relapse of presenting with an initial episode of acute central nervous system inflammatory demyelinating disease(IDDCNS) in children.Methods By group-control study,20 relapsing patients with IDDCNS compared with 50 single episoding patients with IDDCNS whose case history longer than 0.5 year,whose age at onset,gender,preceding infection or immunization,neurologic syndromes at presentation,therapeutic response,and final neurologic outcome after initial episode were analyzed by mono-factor analysis and multi-factor nonconditional Logistic regression model.Results 1.The risk of relapse increased in the near future,75.0% relapsed before 6 months.There were 18 cases diagnosed multiple sclerosis(MS),1 case neurooptic myelitis and 1 case immaturity myelitis in relapsing patients.There were 39 cases diagnosed acute disseminated encephalomyelitis in single episoding patients.2.Mono-factor analysis:8 factors were not statistically significant,including age at onset,gender,seizure,palsy,conscious disturbance,ataxia,natural relief,sequelae after the first attack;6 factors were statistically significant,including infectious or vaccination agents before episode,fever,visual disorder,multiple neurological signs,positive pathologic reflex,with marked improvement to cortical hormone.3.In the multi-factor stepwise regression analysis,visual disorder(OR=42.50)and positive pathologic reflex(OR=8.666)were the independent influencing factors,multiple neurological signs(OR=0.068)was independent protecting factor.Conclusions The rate of relapse in IDDCNS is lower than abroad and most relapse before 0.5 year,the main diagnosis of relapsing case is MS.When visual disorder and positive pathologic reflex presenting in the fist episode of IDDCNS,the opportunity of relapse will increase,and will decrease when multiple neurological signs presenting.