目的　探讨伴甲状腺功能异常的儿童急性播散性脑脊髓炎（ADEM）的临床特征和诊断思路。方法　回顾分 析3例伴甲状腺功能异常的ADEM患儿的临床资料，并复习相关文献。结果　2例男童（分别为3岁10个月、12岁），1例 女童（8岁）。 发病前均有发热， 2例伴睡眠增多， 1例伴烦躁， 1例面神经异常。 3例患儿的甲状腺过氧化物酶均升高，且与 症状严重程度相关； 2例患儿恢复期下降， 1例无明显改变。 3例患儿脑电图均有背景活动减慢； 3例头颅MRI均异常，其中 2例颈MRI也异常。结论　ADEM合并甲状腺功能异常少见，需与桥本脑病相鉴别。

Objective　To explore the clinical features and diagnosis of acute disseminated encephalomyelitis (ADEM) in children with thyroid dysfunction. Methods　The clinical data of ADEM with thyroid dysfunction in 3 children were retrospectively analyzed, and the related literature was reviewed. Results　There were two boys (3 years and 10 months old, 12 years old) and one girl (8 years old). All the children had fever prior to theonset, 2 patients hadincreased sleep, 1 patient hadirritability, and 1 patient hadfacial nerve abnormality. Thyroperoxidase was elevated in all 3 children and correlated with the severity of symptoms. During the recovery period, thyroperoxidase was decreased in 2 children and not significantly changed in 1 child. Electroencephalogram showed that the background activity was decreased in 3 cases. Brain magnetic resonance imaging (MRI) showed abnormal in 3 cases, and neck MRI showed abnormal in 2 cases. Conclusions　ADEM with thyroid dysfunction is rare and should be differentiated from Hashimoto encephalopathy.