Specialist Working Group for Neurology Proposed changes to the Criteria for the clinical use of intravenous immunoglobulin in Australia, Second Edition ITEM CRITERIA FOR THE CLINICAL USE OF PROPOSED REVISIONS TO THE CRITERIA SWG RATIONALE FOR PROPOSED INTRAVENOUS IMMUNOGLOBULIN IN CHANGE AUSTRALIA, SECOND EDITION (CRITERIA) (A) Administrative) (B) Progressive (C) Programmed Condition Name Acute disseminated encephalomyelitis (ADEM) Acute disseminated encephalomyelitis (ADEM) Specialty Neurology Neurology Chapter 6 6 Specific Monophasic ADEM Conditions Recurrent ADEM Multiphasic ADEM Evidence of probable benefit (Category 2a). Level of Evidence Evidence of probable benefit (Category 2a) Justification for On review of multiple case series of IVIg use for On review of multiple case series of intravenous Revised with addition from the Evidence paediatric ADEM found that children with immunoglobulin (IVIg) use for paediatric ADEM IPMSSG (International Paediatric MS Category monophasic ADEM completely recovered after found that children with monophasic ADEM Study Group) in 2014 confirms administration of IVIg or IVIg plus corticosteroids. completely recovered after administration of IVIg category 2a. In recurrent ADEM, children either completely or IVIg plus corticosteroids. In recurrent ADEM, recovered after IVIg, or showed improvement. children either completely recovered after IVIg, Adults with monophasic or recurrent ADEM or showed improvement. Adults with recovered after treatment with IVIg. monophasic or recurrent ADEM recovered after treatment with IVIg. Data from the International Pediatric MS Study Group (IPMSSG) in 2014 confirms this view. Description and High-dose corticosteroids are first-line treatment ADEM is a monophasic inflammatory condition of Revised to describe and require Diagnostic of ADEM. IVIg has been used for patients who fail the central nervous system that usually presents IPMSSG Criteria to be used. Criteria to respond to steroid therapy or in patients where in children and young adults. It typically occurs steroids are contraindicated. Most patients with following a viral prodrome with multifocal ADEM recover completely over a period of six neurological disturbance and altered conscious weeks from onset. state. ADEM usually follows a monophasic
Specialist Working Group for Neurology Proposed changes to the Criteria for the clinical use of intravenous immunoglobulin in Australia, Second Edition ITEM CRITERIA FOR THE CLINICAL USE OF INTRAVENOUS IMMUNOGLOBULIN IN AUSTRALIA, SECOND EDITION (CRITERIA) PROPOSED REVISIONS TO THE CRITERIA SWG RATIONALE FOR PROPOSED CHANGE (A) Administrative) (B) Progressive (C) Programmed Condition Name Acute disseminated encephalomyelitis (ADEM) Acute disseminated encephalomyelitis (ADEM) Specialty Neurology Neurology Chapter 6 6 Specific Conditions Monophasic ADEM Recurrent ADEM Multiphasic ADEM Level of Evidence Evidence of probable benefit (Category 2a). Evidence of probable benefit (Category 2a) Justification for Evidence Category On review of multiple case series of IVIg use for paediatric ADEM found that children with monophasic ADEM completely recovered after administration of IVIg or IVIg plus corticosteroids. In recurrent ADEM, children either completely recovered after IVIg, or showed improvement. Adults with monophasic or recurrent ADEM recovered after treatment with IVIg. On review of multiple case series of intravenous immunoglobulin (IVIg) use for paediatric ADEM found that children with monophasic ADEM completely recovered after administration of IVIg or IVIg plus corticosteroids. In recurrent ADEM, children either completely recovered after IVIg, or showed improvement. Adults with monophasic or recurrent ADEM recovered after treatment with IVIg. Data from the International Pediatric MS Study Group (IPMSSG) in 2014 confirms this view. Revised with addition from the IPMSSG (International Paediatric MS Study Group) in 2014 confirms category 2a. Description and Diagnostic Criteria High-dose corticosteroids are first-line treatment of ADEM. IVIg has been used for patients who fail to respond to steroid therapy or in patients where steroids are contraindicated. Most patients with ADEM recover completely over a period of six weeks from onset. ADEM is a monophasic inflammatory condition of the central nervous system that usually presents in children and young adults. It typically occurs following a viral prodrome with multifocal neurological disturbance and altered conscious state. ADEM usually follows a monophasic Revised to describe and require IPMSSG Criteria to be used.
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