Multimodal evoked potentials are useful for diagnosis of pediatric acute disseminated encephalomyelitis

Background: The applying evoked potentials (EPs) to the diagnosis of acute disseminated encephalomyelitis (ADEM ) has not been investigated in detail. The aim of this study was to analyze multimodal evoked potentials in the early diagnostic value of pediatric ADEM. Methods: : Retrospective study enrolling pediatric ADEM patients and healthy controls (HCs) from neurology units between 2017 to 2021. They were measured with brainstem auditory evoked potentials (BAEPs), visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs), and then analyzed the early diagnostic value in ADEM patients. Results: : A total of 34 children with ADEM (mean age 6 years ; 23 males) and 30 HCs (mean age 6 years ; 17 males) were recruited.As magnetic resonance image (MRI) was the diagnostic criteria, the sensitivity, specificity and accuracy (κwas 0.88) of multimodal evoked potentials were highly consistent with those of MRI, the validity could be ranked in the following order with respect to the diagnosis of ADEM: multimodal evoked potentials＞single SEP＞single VEP＞single BAEP. Among 34 patients with ADEM, the abnormality of multimodal evoked potentials was 94.12％, while the abnormalities of single VEP, BAEP and SEP were 70.59％,64.71％and 85.3％,respectively, and there were significant differences between single VEP/BAEP and multimodal evoked potentials (c 2 =6.476/8.995, P =0.011/0.003). Conclusion: The combined application of multimodal evoked potentials are superior to BAEP, VEP, or SEP alone in detecting the existence of central nerve demyelination, which would be applicable for the early diagnosis of ADEM.