![]() Patterns associated with poor prognosis included ADEM-like relapses with changes that resembled leukodystrophy, and extensive cortical encephalitis evolving to brain atrophy.Īt last follow-up, only five patients (4%) had been diagnosed with multiple sclerosis (MS), supporting the idea that MOG antibody-associated syndromes and MS are different pathological entities, the authors noted. One boy died at 4 days follow-up, and the remaining children had moderate to severe deficits. Most of the 116 patients who were MOG-positive had substantial recovery (85% had a score of 0 or 1 on the modified Rankin scale, indicating no significant disability). Rituximab (Rituxan) was used in 11 children at relapse. Steroids, intravenous immunoglobulin, or plasma exchange were used in 86% of children at diagnosis and 97% of children at relapse. In the first group, the researchers confirmed the association of MOG antibodies with demyelinating syndromes previously known, including acute disseminated encephalomyelitis (ADEM), optic neuritis, and myelitis. Of the 116 children diagnosed with MOG antibodies, 94 (39%) were in the group of demyelinating syndromes and 22 (7%) were in the encephalitis group. "Our study took a novel approach of prospectively examining two large cohorts of pediatric patients, one including 239 patients with demyelinating syndromes and the other 296 patients with all types of consecutively identified encephalitis in 40 Spanish centers," he told MedPage Today. "There have been only a few case reports, mainly including adult patients, suggesting that these antibodies can also occur in patients with encephalitis without overt clinical or MRI findings suggesting demyelinating features," he noted. Most studies about MOG-antibody associated syndromes have focused on acquired demyelinating diseases, Dalmau said. About 85% of those 116 children responded to treatment with complete or near-complete recovery, but 15% experienced severe deficits and one patient died, they reported in Lancet Neurology.
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