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MRI of the first event in pediatric acquired demyelinating syndromes with antibodies to myelin oligodendrocyte glycoprotein

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Abstract

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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Acknowledgements

This work was supported by a grant from the Anniversary Fund of the Austrian National Bank to KR (Grant number 14158); and the research grant “BIG WIG MS” from the Austrian Federal Ministry of Science, Research and Economy to MR.

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Authors and Affiliations

  1. Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Matthias Baumann & Christian Lechner

  2. Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria

    Astrid Grams & Tanja Djurdjevic

  3. Department of Pediatrics, Olga Hospital, Stuttgart, Germany

    Eva-Maria Wendel

  4. Department of Pediatrics, Klinikum Nuremberg, Nuremberg, Germany

    Bettina Behring

  5. Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauner’s Children’s Hospital, University of Munich, Munich, Germany

    Astrid Blaschek

  6. Division of Pediatric Neurology, Department of Pediatrics, Klinikum Kassel, Kassel, Germany

    Katharina Diepold

  7. Department of Pediatrics, Women’s and Children’s Hospital, Linz, Austria

    Astrid Eisenkölbl

  8. Pediatric Neurology, Geneva Children’s Hospital, Geneva, Switzerland

    Joel Fluss

  9. Department of General Paediatrics, Neonatology and Paediatric Cardiology, Heinrich Heine Universität, Düsseldorf, Germany

    Michael Karenfort

  10. Department of Pediatrics, Salzburger Landeskliniken and Paracelsus Medical University, Salzburg, Austria

    Johannes Koch

  11. Department of Pediatric Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Bahadir Konuşkan

  12. Division of Pediatric Neurology, Department of Pediatrics, Klinikum Dritter Orden, Munich, Germany

    Steffen Leiz

  13. Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany

    Andreas Merkenschlager

  14. Department of Neurology, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada

    Daniela Pohl

  15. Division of Pediatric Neurology, Children’s Hospital, Klinikum Augsburg, Augsburg, Germany

    Mareike Schimmel

  16. Department of Neuropediatrics, University Children’s Hospital, Ruhr-University Bochum, Bochum, Germany

    Charlotte Thiels

  17. Institute of Neurology, Medical University of Vienna, Vienna, Austria

    Barbara Kornek

  18. Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    Kathrin Schanda & Markus Reindl

  19. Department of Pediatric Neurology, Children’s Hospital Datteln, Witten/Herdecke University, Datteln, Germany

    Kevin Rostásy

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  1. Matthias Baumann
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  18. Charlotte Thiels
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  19. Barbara Kornek
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  20. Kathrin Schanda
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  21. Markus Reindl
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  22. Kevin Rostásy
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Corresponding author

Correspondence to Matthias Baumann.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Approval for this study was obtained from the institution’s review board. All included patients or caregivers provided written informed consent.

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Baumann, M., Grams, A., Djurdjevic, T. et al. MRI of the first event in pediatric acquired demyelinating syndromes with antibodies to myelin oligodendrocyte glycoprotein. J Neurol 265, 845–855 (2018). https://doi.org/10.1007/s00415-018-8781-3

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  • DOI: https://doi.org/10.1007/s00415-018-8781-3

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