E.U. paediatric MOG consortium consensus: Part 1 – Classification of clinical phenotypes of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders
Journal: European Journal of Pediatric Neurology; November 1, 2020
Author(s): Arlette L. Bruijstensa, Christian Lechnerb, Lorraine Flet-Berliacc, Kumaran Deivac, Rinze F. Neutebooma, Cheryl Hemingwaye, Evangeline Wassmerf, on behalf of the E.U. paediatric MOG consortium
The different forms MOGAD takes in children
MOGAD can look very different from one child to another, making it difficult to diagnose. This review, conducted by a group of experts focused on MOGAD in children, brings together evidence from many studies to help doctors better recognize the different forms MOGAD can take in children.
MOGAD is generally more common in children than in adults, with boys and girls affected almost equally. The review found that a child’s age often influences how MOGAD first appears. Younger children are more likely to develop brain inflammation, also known as acute disseminated encephalomyelitis (ADEM), which often leads to symptoms such as confusion, drowsiness, or changes in behavior. Older children and teenagers are more likely to experience eye inflammation (optic neuritis), which affects vision, or spinal cord inflammation (transverse myelitis), which can cause weakness, numbness, or bladder and bowel problems.
Although many children experience only one attack, some go on to have relapses. Older children seem to have greater chances of developing relapsing MOGAD.
In case of relapses, younger children are more likely to have repeated episodes of ADEM or optic neuritis following ADEM, while older children more commonly develop recurrent optic neuritis or attacks affecting both the optic nerves and spinal cord.
Since MOGAD can show up in many different forms in children, the authors recommend that all children with unexplained inflammatory conditions affecting the brain, optic nerves, or spinal cord should be tested for MOG antibodies. Early diagnosis can help doctors choose the most appropriate treatment, estimate the risk of future relapses, and provide better information to families. The review also recommends simultaneously testing for aquaporin-4 (AQP-4) antibodies, which are used to diagnose neuromyelitis optica spectrum disorder or NMOSD), as it can be difficult to distinguish between these two conditions that require different long-term management.
Related article: Attack phenotypes and disease course in pediatric MOGAD
Free Access: Full text