Plasmapheresis in acute disseminated encephalomyelitis.

High-dose corticosteroid administration has been regarded as the main therapy for acute disseminated encephalomyelitis (ADEM). However, some patients with ADEM do not respond well to this treatment. We successfully used plasmapheresis to treat 2 patients who had ADEM. We also compared our patients' symptoms and clinical outcomes to those from previous reports. Plasmapheresis may be indicated not only for severe cases that fail to improve after high-dose corticosteroid treatment but also for first-line treatment. Additional large, controlled, double-blinded trials are needed to clarify the role of plasmapheresis in ADEM. (c) 2004 Wiley-Liss, Inc.