Acute disseminated encephalomyelitis followed by recurrent or monophasic optic neuritis in pediatric patients.

Abstract

BACKGROUND:

Some pediatric patients with inflammatory demyelinating central nervous system disorders cannot be classified under any of the established disease entities, making their treatment and prognosis difficult.

OBJECTIVE:

The objective of this study is to characterize a subgroup of pediatric patients with recurrent demyelinating central nervous system disorders.

METHODS:

This study includes a case series of pediatric patients with monophasic or recurrent acute disseminated encephalomyelitis (ADEM) who later presented with either monophasic or recurrent optic neuritis (ON).

RESULTS:

We describe seven patients with a median follow-up of six years (five females, two males) who presented at a median age of 6 years (range 4-8 years) with monophasic (n = 4) or recurrent ADEM (two to four attacks) followed by monophasic (n = 3) or recurrent ON (two to nine attacks). Cranial magnetic resonance imaging (MRI) was typical for ADEM (n = 6) with complete or almost complete resolution of lesions on follow-up. Cerebrospinal (CSF) studies at the time of ADEM showed a pleocytosis in six patients and were negative for oligoclonal bands (OCBs) in all. In all patients high titers for serum anti-MOG antibodies were detected.

CONCLUSION:

ADEM followed by ON is a rare but distinct clinical phenotype among pediatric patients. Further studies are needed to allow recommendations on treatment or prognosis.

• Authors: Peter Huppke, Kevin Rostasy, Michael Karenfort, Brenda Huppke, Rainer Seidl, Steffen Leiz, Markus Reindl, Jutta Gärtner
• Journal: Multiple sclerosis (Houndmills, Basingstoke, England) (Mult Scler) Vol. 19 Issue 7 Pg. 941-6 (Jun 2013) ISSN: 1477-0970 [Electronic] England
• PMID: 23128668 (Publication Type: Journal Article)

Topics

• Child
• Child, Preschool
• Encephalomyelitis, Acute Disseminated (complications, pathology, physiopathology)
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Optic Neuritis (complications, pathology, physiopathology)