Long term outcome in non-multiple sclerosis paediatric acquired demyelinating syndromes.
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All Authors
Wassmer, E.
Billaud, C.
Absoud, M.
Abdel-Mannan, O.
Benetou, C.
Cummins, C.
Forrest, K.
De Goede, C.
Eltantawi, N.
Hickson, H.
LTHT Author
Livingston, John
Taylor, Micheal
Taylor, Micheal
LTHT Department
Leeds Children's Hospital
Children's Neurosciences
Children's Neurosciences
Non Medic
Publication Date
2024
Item Type
Journal Article
Multicenter Study
Multicenter Study
Language
Subject
Subject Headings
Abstract
OBJECTIVES: We aimed to study the risks of relapse and long term disability in children with non-MS acquired demyelinating syndromes (ADS).
METHODS: In this prospective, multi-centre study, from the 14 UK pediatric neurology centres, children (<16 years) experiencing a first episode of ADS were recruited from 2010 to 2014. Case report forms were collected prospectively.
RESULTS: A total of 269 children were recruited and followed up for a median of 7.2 years. Median age at onset was 9y (IQR 9.5-14.5, 126 females). At last follow-up, 46 (18 %) had MS, 4 AQP4-Ab NMOSD and 206 (80 %) had other ADS, of which 27 (13 %) relapsed. Relapsing MOGAD was the diagnosis in 12/27, 6 were seronegative and 9 did not have antibodies tested. Frequency of relapse differed according to first presentation in non-MS ADS, being least likely in transverse myelitis (p = 0.025). In the non-MS group, MOG-Ab was predictive of relapse (HR = 8.42; p < 0.001) occurring 8 times as often decreasing over time. Long-term difficulties did not differ between children with monophasic vs relapsing diseases.
CONCLUSION: The risk of relapse in non-MS ADS depends on initial diagnosis, and MOG-Ab positivity. Long-term difficulties are observed regardless of relapses and are determined by presenting phenotype.
Journal
European Journal of Paediatric Neurology