Acute Disseminated Encephalomyelitis (ADEM) and Increased Intracranial Pressure Associated With Anti–Myelin Oligodendrocyte Glycoprotein Antibodies

Ram N. Narayan, Cynthia Wang, Benjamin Greenberg

Research output: Contribution to journalArticle

Abstract

Background: The presence of antibodies to the myelin oligodendrocyte glycoprotein (MOG) has been identified in about 40% of children with acute disseminated encephalomyelitis (ADEM). The objective of this report was to describe three fulminant cases of ADEM complicated by increased intracranial pressure associated with the presence of the anti-MOG antibodies. Methods: This is a retrospective case series. Informed consent was obtained from the concerned patients or caregivers. Results: High intracranial pressure associated with ADEM in the presence of MOG antibodies can result in cerebral edema, herniation, prolonged hospital stay (average intensive care unit stay: 22 days, average hospital stay: 50.6 days), and long-term disability. Conclusion: Increased intracranial pressure complicating MOG antibody—related ADEM is a unique finding in our cases. This can complicate the clinical picture of ADEM and confers high morbidity. Long-term immunosuppression is warranted in selected cases with persistent seropositivity.

Original languageEnglish (US)
JournalPediatric Neurology
DOIs
StatePublished - Jan 1 2019

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Acute Disseminated Encephalomyelitis
Myelin-Oligodendrocyte Glycoprotein
Oligodendroglia
Intracranial Pressure
Glycoproteins
Antibodies
Length of Stay
Brain Edema
Informed Consent
Immunosuppression
Caregivers
Intensive Care Units
Morbidity

Keywords

  • Acute disseminated encephalomyelitis
  • Cerebral edema
  • Herniation
  • Intracranial pressure
  • Myelin oligodendrocyte Glycoprotein
  • Optic neuritis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

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title = "Acute Disseminated Encephalomyelitis (ADEM) and Increased Intracranial Pressure Associated With Anti–Myelin Oligodendrocyte Glycoprotein Antibodies",
abstract = "Background: The presence of antibodies to the myelin oligodendrocyte glycoprotein (MOG) has been identified in about 40{\%} of children with acute disseminated encephalomyelitis (ADEM). The objective of this report was to describe three fulminant cases of ADEM complicated by increased intracranial pressure associated with the presence of the anti-MOG antibodies. Methods: This is a retrospective case series. Informed consent was obtained from the concerned patients or caregivers. Results: High intracranial pressure associated with ADEM in the presence of MOG antibodies can result in cerebral edema, herniation, prolonged hospital stay (average intensive care unit stay: 22 days, average hospital stay: 50.6 days), and long-term disability. Conclusion: Increased intracranial pressure complicating MOG antibody—related ADEM is a unique finding in our cases. This can complicate the clinical picture of ADEM and confers high morbidity. Long-term immunosuppression is warranted in selected cases with persistent seropositivity.",
keywords = "Acute disseminated encephalomyelitis, Cerebral edema, Herniation, Intracranial pressure, Myelin oligodendrocyte Glycoprotein, Optic neuritis",
author = "Narayan, {Ram N.} and Cynthia Wang and Benjamin Greenberg",
year = "2019",
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doi = "10.1016/j.pediatrneurol.2019.03.009",
language = "English (US)",
journal = "Pediatric Neurology",
issn = "0887-8994",
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AU - Narayan, Ram N.

AU - Wang, Cynthia

AU - Greenberg, Benjamin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The presence of antibodies to the myelin oligodendrocyte glycoprotein (MOG) has been identified in about 40% of children with acute disseminated encephalomyelitis (ADEM). The objective of this report was to describe three fulminant cases of ADEM complicated by increased intracranial pressure associated with the presence of the anti-MOG antibodies. Methods: This is a retrospective case series. Informed consent was obtained from the concerned patients or caregivers. Results: High intracranial pressure associated with ADEM in the presence of MOG antibodies can result in cerebral edema, herniation, prolonged hospital stay (average intensive care unit stay: 22 days, average hospital stay: 50.6 days), and long-term disability. Conclusion: Increased intracranial pressure complicating MOG antibody—related ADEM is a unique finding in our cases. This can complicate the clinical picture of ADEM and confers high morbidity. Long-term immunosuppression is warranted in selected cases with persistent seropositivity.

AB - Background: The presence of antibodies to the myelin oligodendrocyte glycoprotein (MOG) has been identified in about 40% of children with acute disseminated encephalomyelitis (ADEM). The objective of this report was to describe three fulminant cases of ADEM complicated by increased intracranial pressure associated with the presence of the anti-MOG antibodies. Methods: This is a retrospective case series. Informed consent was obtained from the concerned patients or caregivers. Results: High intracranial pressure associated with ADEM in the presence of MOG antibodies can result in cerebral edema, herniation, prolonged hospital stay (average intensive care unit stay: 22 days, average hospital stay: 50.6 days), and long-term disability. Conclusion: Increased intracranial pressure complicating MOG antibody—related ADEM is a unique finding in our cases. This can complicate the clinical picture of ADEM and confers high morbidity. Long-term immunosuppression is warranted in selected cases with persistent seropositivity.

KW - Acute disseminated encephalomyelitis

KW - Cerebral edema

KW - Herniation

KW - Intracranial pressure

KW - Myelin oligodendrocyte Glycoprotein

KW - Optic neuritis

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