Acute Disseminated Encephalomyelitis in Children and Adolescents: A Multicenter Retrospective Study of Relapse and Outcome
Kanmaz, Seda, Yilmaz, Sanem, Dundar, Nihal Olgac, Aksoy, Ayse, Canpolat, Mehmet, Per, Huseyin, Erol, Ilknur, Gumus, Hakan, Ozkale, Yasemin, Ozturk, Selcan, Toprak, Dilara Ece, Oncel, Ibrahim, Ozkale, Murat, Ozmansur, Elif Nurdan, Serin, Hepsen Mine, Ersoz, Gulsen, Besen, Seyda, Mert, Gulen Gul, Gulec, Ayten, Sahin, Sevim, Olculu, Cemile Busra, Selek, Ayberk, Pekuz, Serdar, Basarir, Gunce, Gunay, Cagatay, Bicer, Didem, Kahraman, Zehra Filiz, Yuksel, Deniz, Karadag, Meral, Simsek, Erdem, Unalp, Aycan, Yildiz, Nihal, Direk, Meltem Cobanogullari, Yis, Uluc, Tan, Huseyin, Havali, Cengiz, Degerliyurt, Aydan, Gungor, Mesut, Herguner, Ozlem, Oncel, Elif Perihan, Unver, Olcay, Kumandas, Sefer, Celik, Hale Atalay, Ozgor, Bilge, Cansu, Ali, Atasever, Asli Kubra, Tosun, Ayse, Gungor, Olcay, Okuyaz, Cetin, Edizer, Selvinaz, Hiz, Semra, Sarigecili, Esra, Kayilioglu, Hulya, Yazgan, Ceren Durgun, Tuncer, Gokcen Oz, Gencpinar, Pinar, Yilmaz, Unsal, Ozgur, Su, Tekgul, Hasan, Anlar, Banu
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.
- Dergi
- JOURNAL OF CHILD NEUROLOGY
- Yıl
- 2025
- Cilt
- 40
- Sayı
- 10
- Sayfa
- 838-851
- ISSN
- 0883-0738
- eISSN
- 1708-8283
- DOI
- 10.1177/08830738251334219
- WoS UID
- WOS:001590983700006