Acute Disseminated Encephalomyelitis in Children and Adolescents: A Multicenter Retrospective Study of Relapse and Outcome
Makaleler > Tam Makale · 2025
Yazarlar: Seda KANMAZ, Sanem KESKİN YILMAZ, Nihal Olgaç Dündar, Ayşe Aksoy, Mehmet Canpolat, Hüseyin Per, İlknur Erol, Hakan Gümüş, Yasemin Özkale, Selcan Öztürk, Dilara Ece TOPRAK DOĞAN, İbrahim Öncel, Murat Özkale, Elif Nurdan Ozmansur, Hepsen Mine SERİN, Gülşen Ersöz, Şeyda Besen, Gülen Gül Mert, Ayten Güleç, Sevim Şahin, Cemile Büşra ÖLÇÜLÜ, Ayberk Selek, Serdar Pekuz, Günce Başarır, Çağatay Günay, Didem Biçer, Zehra Filiz Kahraman, Deniz Yüksel, Meral Karadağ, ERDEM ŞİMŞEK, Aycan Ünalp, Nihal Yıldız, Meltem Çobanoğulları Direk, Uluç Yiş, Hüseyin Tan, Cengiz Havalı, Aydan Değerliyurt, Mesut Güngör, Özlem Hergüner, Elif Perihan Oncel, Olcay Ünver, Sefer Kumandaş, Hale Atalay Celik, Bilge Özgör, Ali Cansu, Aslı Kübra Atasever, Ayşe Tosun, Olcay Güngör, Çetin Okuyaz, Selvinaz Edizer, Semra Hız, Esra Sarıgeçili, Hülya Kayılıoğlu, Ceren Durgun Yazgan, Gökçen Öz Tuncer, Pınar Gençpınar, Ünsal Yılmaz, Su Özgür, Hasan TEKGÜL, Banu Anlar
Journal of Child Neurology, Uluslararası, Wos, 2025, cilt 40, ss 838-851
DOI: 10.1177/08830738251334219
Özet
Objectives To evaluate the demographic, clinical, laboratory, and prognostic data of children with acute disseminated encephalomyelitis with respect to anti-myelin oligodendrocyte glycoprotein (MOG) antibody status. Methods Acute 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. Results The 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%, P = .164) or incomplete clinical recovery ( P = .511). Conclusion The 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.