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

作者：Huppke Peter^*; Rostasy Kevin; Karenfort Michael; Huppke Brenda; Seidl Rainer; Leiz Steffen; Reindl Markus; Gaertner Jutta

来源：Multiple Sclerosis, 2013, 19(7): 941-946.

DOI：10.1177/1352458512466317

• ADEM
• NMO
• optic neuritis
• pediatric

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. %26lt;br%26gt;Objective: The objective of this study is to characterize a subgroup of pediatric patients with recurrent demyelinating central nervous system disorders. %26lt;br%26gt;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). %26lt;br%26gt;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. %26lt;br%26gt;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.

• 出版日期2013-6