Journal
JOURNAL OF NEUROLOGY
Volume 265, Issue 4, Pages 845-855Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00415-018-8781-3
Keywords
Pediatric acquired demyelinating syndromes; Myelin oligodendrocyte glycoprotein; Acute disseminated encephalomyelitis; Neuromyelitis optica spectrum disorder; Multiple sclerosis; Magnetic resonance imaging
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Funding
- Anniversary Fund of the Austrian National Bank [14158]
- research grant BIG WIG MS from the Austrian Federal Ministry of Science, Research and Economy
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Antibodies against the myelin oligodendrocyte glycoprotein (MOG-Ab) can be detected in various pediatric acquired demyelinating syndromes (ADS). Here, we analyze the spectrum of neuroradiologic findings in children with MOG-Ab and a first demyelinating event. The cerebral and spinal MRI of 69 children with different ADS was assessed in regard to the distribution and characteristics of lesions. Children with acute disseminated encephalomyelitis (n = 36) or neuromyelitis optica spectrum disorder (n = 5) presented an imaging pattern characterized predominantly by poorly demarcated lesions with a wide supra- and infratentorial distribution. Younger children also tended to have poorly defined and widespread lesions. The majority of patients with an isolated optic neuritis (n = 16) only presented small non-specific brain lesions or none at all. A longitudinally extensive transverse myelitis mainly affecting the cervical, and less often so the thoracic, lumbar, and conus regions, was detected in 31 children. The three children of our cohort who were then finally diagnosed with multiple sclerosis had at onset already demarcated white matter lesions as well as transverse myelitis. In conclusion, children with MOG seropositive ADS present disparate, yet characteristic imaging patterns. These patterns have been seen to correlate to the disease entity as well as to age of symptom onset.
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