Introduction Acute disseminated encephalomyelitis (ADEM) in an acute inflammatory demyelinating disease of the central nervous system that is typically preceded by an infectious illness or a vaccination. Steroid treatment has been the most widely reported therapy for ADEM. However, there has been great variety in the specific steroid formulations employed, routes of administration, dosing and tapering regimens. We describe the effect of high-dose intravenous methylprednisolone in ADEM.

Methods A six year retrospective chart review of children with diagnosis of ADEM who were treated with high-dose intravenous methylprednisolone was conducted.

Results Six cases were identified; there were three male and three female patients. Four children had a recent viral illness and the other patients a vaccination. All patients were treated with high-dose intravenous methylprednisolone (30 mg/kg/day for 5 days), followed by oral steroid taper for 6 weeks. Overall, five children had remarkably responded to high-dose methylprednisolone alone and recovered within the first week. One patient had long-term neurologic sequelae. No undesirable effect with steroids has been noted.

Conclusion Our experience indicates that high-dose methylprednisolone is efficacious in pediatric-onset acute encephalomyelitis.