Acute Disseminated Encephalomyelitis in Children and Adolescents: A Multicenter Retrospective Study of Relapse and Outcome

ObjectivesTo evaluate the demographic, clinical, laboratory, and prognostic data of children with acute disseminated encephalomyelitis with respect to anti-myelin oligodendrocyte glycoprotein (MOG) antibody status.MethodsAcute disseminated encephalomyelitis patients (n = 245) from 24 centers followed up between 2010 and 2022 were evaluated retrospectively. The short- and long-term outcome characteristics (disease severity and course, clinical relapse, and recovery rates) were assessed. Incomplete clinical recovery was defined as modified Rankin Score ≥1 or the presence of epilepsy. Univariant and multivariant analysis were performed for outcome characteristics.ResultsThe mean age at diagnosis was 6.3 ± 3.8 (0.5-17.7) years and the median follow-up was 22 (3-132) months. The outcome characteristics were evaluated in 180 of 245 patients (73.4%) with at least 12 months' follow-up. Twenty-three patients (12.6%) relapsed. The multivariable logistic regression analysis revealed the following clinical parameters as predictors of relapse: sex, visual impairment, and ataxia at initial presentation. Incomplete clinical recovery (n = 42/180, 23.3%) was associated with the presence of seizures on admission and the need for an intensive care unit. Anti-MOG antibody positivity was not associated with an increased risk of relapse (25% vs 13.1%, <i>P</i> = .164) or incomplete clinical recovery (<i>P</i> = .511).ConclusionThe nationwide cohort presented further supports the typically monophasic nature of acute disseminated encephalomyelitis, and a high rate of complete recovery. The presence of certain symptoms in the acute period may assist the clinician in estimating the outcome.

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Journal
Journal of Child Neurology
Published
2025-05-08
DOI
https://doi.org/10.1177/08830738251334219
Primary Topic
Multiple Sclerosis Research Studies
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article

Acute Disseminated Encephalomyelitis in Children and Adolescents: A Multicenter Retrospective Study of Relapse and Outcome

Dilara Ece Toprak, Ayşe Aksoy, Pınar Gençpınar, Günce Başarır et al.
Journal of Child Neurology
Multiple Sclerosis Research Studies
article

Acute Disseminated Encephalomyelitis in Children and Adolescents: A Multicenter Retrospective Study of Relapse and Outcome

Dilara Ece Toprak, Ayşe Aksoy, Pınar Gençpınar, Günce Başarır, Hepsen Mine Serin, Cemile Büşra Ölçülü, Uluç Yiş, Mehmet Canpolat, Gülen Gül Mert, Sevim Şahin, Gülfem Ersöz, Cengiz Havalı, Aydan Değerli̇yurt, Nihal Olgaç Dündar, E. Mansur, Murat Özkale, Şeyda Beşen, İlknur Erol, Ayten Güleç, Deniz Yüksel, Ünsal Yılmaz, İbrahim Öncel, Özlem Hergüner, Elif Perihan Öncel, Hasan Tekgül, Meral Karadağ, Aycan Ünalp, Selvinaz Edizer, Didem Biçer, Ayberk Selek, Seda Kanmaz, Sefer Kumandaş, Meltem Çobanoğulları Direk, Hüseyin Tan, Su Özgür, Hüseyin Per, Gökçen Öz Tuncer, Hakan Gümüş, Ali Cansu, Esra Sarıgeçili, Olcay I. Unver, Nihal Yıldız, Yasemin Özkale, Bilge Özgör, Ayşe Tosun, Mesut Güngör, Banu Anlar, Aslı Kübra Atasever, Çağatay Günay, Erdem Şimşek, Selcan Öztürk, Semra Hız Kurul, Hülya Kayılıoğlu, Olcay Güngör, Hale Atalay Çelik, Çetin Okuyaz, Sanem Keskin Yılmaz, Zehra Filiz Kahraman, Ceren Durgun Yazgan
article en

Abstract

ObjectivesTo evaluate the demographic, clinical, laboratory, and prognostic data of children with acute disseminated encephalomyelitis with respect to anti-myelin oligodendrocyte glycoprotein (MOG) antibody status.MethodsAcute disseminated encephalomyelitis patients (n = 245) from 24 centers followed up between 2010 and 2022 were evaluated retrospectively. The short- and long-term outcome characteristics (disease severity and course, clinical relapse, and recovery rates) were assessed. Incomplete clinical recovery was defined as modified Rankin Score ≥1 or the presence of epilepsy. Univariant and multivariant analysis were performed for outcome characteristics.ResultsThe mean age at diagnosis was 6.3 ± 3.8 (0.5-17.7) years and the median follow-up was 22 (3-132) months. The outcome characteristics were evaluated in 180 of 245 patients (73.4%) with at least 12 months' follow-up. Twenty-three patients (12.6%) relapsed. The multivariable logistic regression analysis revealed the following clinical parameters as predictors of relapse: sex, visual impairment, and ataxia at initial presentation. Incomplete clinical recovery (n = 42/180, 23.3%) was associated with the presence of seizures on admission and the need for an intensive care unit. Anti-MOG antibody positivity was not associated with an increased risk of relapse (25% vs 13.1%, <i>P</i> = .164) or incomplete clinical recovery (<i>P</i> = .511).ConclusionThe nationwide cohort presented further supports the typically monophasic nature of acute disseminated encephalomyelitis, and a high rate of complete recovery. The presence of certain symptoms in the acute period may assist the clinician in estimating the outcome.

Journal of Child NeurologyVol. 40(10)
Izmir University (TR), Karadeniz Technical University (TR), Manisa Celal Bayar University (TR), Bilkent University (TR), Başkent University (TR), Dokuz Eylül University (TR), Ondokuz Mayıs University (TR), Izmir Kâtip Çelebi University (TR), Bezmiâlem Vakıf Üniversitesi (TR), Ege University (TR), Sağlık Bilimleri Üniversitesi (TR), S.B.Ü. Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi (TR), Pamukkale University (TR), Mersin Üniversitesi (TR), Kocaeli Üniversitesi (TR), Cukurova University (TR), Atatürk University (TR), Turgut Özal University (TR), Hacettepe University (TR), Marmara University (TR), Adnan Menderes University (TR), Muğla University (TR), Erciyes University (TR)
Good health and well-being
Openalex Percentile: Top 86%
Multiple Sclerosis Research Studies
DOISourceOpenAlex
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