About 70% of survivors show residual neurological deficits, but some survivors have shown surprisingly little deficit considering the magnitude of the white matter affected.This disease has been occasionally associated with ulcerative colitis and Crohns disease, malaria, sepsis associated with immune complex deposition, methanol poisoning, and other underlying conditions. Also anecdotal association with MS has been reportedLaboratory studies that support diagnosis of AHL are: peripheral leukocytosis, cerebrospinal fluid (CSF) pleocytosis associated with normal glucose and increased protein. On magnetic resonance imaging (MRI), lesions of AHL typically show extensive T2-weighted and fluid-attenuated inversion recovery (FLAIR) white matter hyperintensities with areas of hemorrhages, significant edema, and mass effect. Treatment
No controlled clinical trials have been conducted on ADEM treatment, but aggressive treatment aimed at rapidly reducing inflammation of the CNS is standard. The widely accepted first-line treatment is high doses of intravenous corticosteroids, such as methylprednisolone or dexamethasone, followed by 3–6 weeks of gradually lower oral doses of prednisolone. Patients treated with methylprednisolone have shown better outcomes than those treated with dexamethasone. Oral tapers of less than three weeks duration show a higher chance of relapsing, and tend to show poorer outcomes. Other anti-inflammatory and immunosuppressive therapies have been reported to show beneficial effect, such as plasmapheresis, high doses of intravenous immunoglobulin (IVIg), mitoxantrone and cyclophosphamide.
However, those products were too concentrated and alkaline for use on wounds, as they strongly irritated healthy tissues.Almost a century later Carrel and Dakin observed that few doctors at the time practiced asepsis, and moreover there were no studies of the effectiveness of various antiseptics for wounds. They set out to look for a substance that did not irritate skin, yet had sufficient bactericidal power. Dakin tested more than 200 substances, measuring their action on tissues and bacteria. He found chloramines to be the best, for being stable, non-toxic, and not very irritating, yet powerful bactericides, presumably due to their release of hypochlorous acid. However, the difficulty of procuring them led him to choose "hypochlorite of soda" as a practical alternative.Between the two World Wars, the preparation was often called "Carrel–Dakin solution," even though Dakin did the bulk of the research work that led to its formulation. The name of Carrel was dropped after World War II, presumably due to his active involvement in eugenics movements and the advocacy of elimination of "inferior" humans.Since penicillin became established as an antibiotic in 1943, use of Dakins solution and other topical antiseptics for wound treatment has declined, and their use is frowned upon in modern medical care. However, the solution continues to be used (as of 2013) due to its broad activity against aerobic and anaerobic organisms, including fungi and antibiotic-resistant organisms, its very low cost, and its wide availability. In emergency situations, it can be produced on the field from liquid bleach and sodium bicarbonate.