D Doig1, C McNamara2, L Mewasingh3, S Beri3, B Jones2, C Kachramanoglou2, W Jan2. 1. Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, WC1N 3BG, UK. david.doig@nhs.net. 2. Imaging Department, Imperial College Healthcare NHS Trust, London, UK. 3. Paediatric Neurology Department, Imperial College Healthcare NHS Trust, London, UK.
Abstract
PURPOSE: Anti-myelin oligodendrocyte glycoprotein antibodies (anti-MOG), directed against a component of the myelin sheath, are sometimes detected in the blood or cerebrospinal fluid (CSF) of patients with acute demyelinating conditions. Cortical encephalitic presentations in anti-MOG-antibody-positive patients are recognized but rare, and few pediatric cases have been described. METHODS: We describe clinical, biochemical, and MRI findings in two children presenting with generalized seizures due to cortical encephalitis, and review potential underlying immunological processes. RESULTS: In both patients, anti-MOG antibodies were detected. Both underwent MRI scans which demonstrated bilateral cortical swelling and T2/fluid-attenuated inversion recovery (FLAIR) hyperintensity with corresponding regions of reduced diffusion. CONCLUSION: Early detection of anti-MOG antibodies in patients with a similar presentation and imaging features would enable rapid institution of appropriate treatment, and potentially reduce the need for invasive diagnostic procedures such as brain biopsy.
PURPOSE: Anti-myelin oligodendrocyte glycoprotein antibodies (anti-MOG), directed against a component of the myelin sheath, are sometimes detected in the blood or cerebrospinal fluid (CSF) of patients with acute demyelinating conditions. Cortical encephalitic presentations in anti-MOG-antibody-positive patients are recognized but rare, and few pediatric cases have been described. METHODS: We describe clinical, biochemical, and MRI findings in two children presenting with generalized seizures due to cortical encephalitis, and review potential underlying immunological processes. RESULTS: In both patients, anti-MOG antibodies were detected. Both underwent MRI scans which demonstrated bilateral cortical swelling and T2/fluid-attenuated inversion recovery (FLAIR) hyperintensity with corresponding regions of reduced diffusion. CONCLUSION: Early detection of anti-MOG antibodies in patients with a similar presentation and imaging features would enable rapid institution of appropriate treatment, and potentially reduce the need for invasive diagnostic procedures such as brain biopsy.
Authors: Shahd H M Hamid; Dan Whittam; Mariyam Saviour; Amal Alorainy; Kerry Mutch; Samantha Linaker; Tom Solomon; Maneesh Bhojak; Mark Woodhall; Patrick Waters; Richard Appleton; Martin Duddy; Anu Jacob Journal: JAMA Neurol Date: 2018-01-01 Impact factor: 18.302