E.U. paediatric MOG consortium consensus: Part 2 – Neuroimaging features of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders
Journal: European Journal of Pediatric Neurology; November 1, 2020
Author(s): Matthias Baumanna; Frederik Bartels, Carsten Finke, Catherine Adamsbaumc, Yael Hacohend, Kevin Rostásye, on behalf of the E.U. paediatric MOG consortium
What MRI scans can reveal about MOGAD in children
MRI scans play an important role in diagnosing MOGAD because they allow doctors to see inflammation affecting the brain, spinal cord, and optic nerves. This paper is part of an in-depth review on childhood MOGAD and brings together evidence about the imaging patterns most commonly seen in children with MOGAD and how these may help distinguish MOGAD from conditions such as multiple sclerosis (MS) and aquaporin-4 (AQP-4) antibody-positive neuromyelitis optica spectrum disorder (NMOSD).
How MOGAD shows up on an MRI often depends on the child’s age and the form the condition takes. In children with brain inflammation, also known as acute disseminated encephalomyelitis (ADEM), brain scans typically show large, blurred areas of inflammation affecting the brain’s white matter and deeper grey matter.
In children with spinal cord inflammation, also known as transverse myelitis, MRI scans often show a long area of inflammation extending across three or more sections of the spine. Occasionally, children may have MOG-antibody-positive spinal cord inflammation even the MRI scans appear normal.
Optic neuritis, which is inflammation of the nerves connecting the eyes to the brain, is also an important feature to pay attention to in MRI scans for MOGAD. The inflammation often affects a long section near the front of the optic nerve and commonly involves the tissue surrounding the nerve. Both optic nerves can be affected at the same time, and inflammation may show up in MRI scans even when the patient seems to have symptoms in only one eye.
MRI scans can provide important clues for the diagnosis of MOGAD in children, but the scan results cannot be considered just by themselves. Doctors must interpret them alongside the child’s symptoms, physical examination, and antibody test results.
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