Acute disseminated encephalomyelitis treated with plasmapheresis

R RamachandranNair, M Parameswaran, AS Girija
Correspondence: Dr Rajesh RamachandranNair, drrajeshram@rediffmail.com

ABSTRACT
Accepted modes of therapy in acute disseminated encephalomyelitis include intravenous methyl prednisolone, intravenous immunoglobulin or a combination of both. Effectiveness of plasmapheresis has been demonstrated by previous case reports. We report two patients with steroid non-responsive acute disseminated encephalomyelitis in which plasmapheresis resulted in complete clinical and radiological recovery, though the therapy was initiated in the fifth week of illness. A total of 45-50 ml/kg body weight of plasma was removed in six equal exchanges over a period of two weeks. This report highlights that plasmapheresis could be of use even in the early second month of illness.

Keywords: acute disseminated encephalomyelitis, demyelinating disease, encephalomyelitis, immunotherapy, plasmapheresis
Singapore Med J 2005; 46(10): 561-563