Acquired Demyelinating Syndrome: Single Center Experience

Abstract

INTRODUCTION: Acquired demyelinating syndromes are immune-mediated demyelinating disorders of the central nervous system. Clinical spectrum includes acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, clinically isolated syndrome, and neuromyelitis optica. Aim of this study is to present the clinical features of patients demyelinating disease other than multiple sclerosis and our therapeutic experience. METHODS: Data of 30 patients with acquired demyelinating disease followed up in Ege University Department of Child Neurology between January 2013 and January 2018 were evaluated retrospectively. Demographic data, complaints, clinical and neuroimaging findings, laboratory results, ophthalmologic findings and treatment were recorded. RESULTS: The age of the patients ranged between 3-15 years and mean age was 8.76 +- 3.59 years. The most common diagnosis was acute disseminated encephalomyelitis. The most common complaints were ataxia, headache, encephalopathy, pleome (mono + paraplegia), blurred vision and visual loss respectively. Tests were negative for oligoclonal banding in all patients. Anti-myelin oligodendrocyte antibody was positive in seven patients. One of these patients was double positive for both anti-aquaporin 4 and anti-myelin oligodendrocyte antibodies. Neuroimaging revealed findings consistent with cerebral white matter, spinal cord and optic nerve involvement. All patients were given intravenous pulse methylprednisolone therapy for the acute period DISCUSSION AND CONCLUSION: Since childhood acquired demyelinating diseases may be the first episode of multiple sclerosis, it is important to perform detailed serological tests and CSF examinations for follow-up and differential diagnosis.

Keywords

• childhood
• demyelinating syndrome
• acute disseminated encephalomyelitis
• optic neuritis