A comparison of pediatric and adult neuromyelitis optica spectrum disorders: A review of clinical manifestation, diagnosis, and treatment

Baghbanian, Seyed Mohammad; Asgari, Nasrin; Sahraian, Mohammad Ali; Moghadasi, Abdorreza Naser

doi:10.1016/j.jns.2018.02.028

Cited by 30 publications

(15 citation statements)

References 146 publications

(159 reference statements)

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“…Diplopia, facial palsy, hearing loss, hypogeusia, pruritus, trigeminal neuralgia, vestibular ataxia, and dysarthria may be observed at similar frequencies in children (40%) and adult (33–39%) patients with AQP4-IgG seropositive NMOSD in the early stages of the disease ( 32 , 33 ). Neurogenic respiratory dysfunction due to medullary respiratory center dysfunction is a possible brainstem symptom.…”

Section: Review Of Current Knowledgementioning

confidence: 99%

Pediatric NMOSD: A Review and Position Statement on Approach to Work-Up and Diagnosis

Tenembaum

Yeh

2020

Front. Pediatr.

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Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory demyelinating disease of the central nervous system (CNS) primarily affecting the optic nerves and spinal cord, but also involving other regions of the CNS including the area postrema, periaqueductal gray matter, and hypothalamus. Knowledge related to pediatric manifestations of NMOSD has grown in recent years, particularly in light of newer information regarding the importance of not only antibodies to aquaporin 4 (AQP4-IgG) but also myelin oligodendrocyte glycoprotein (MOG-IgG) in children manifesting clinically with this syndrome. In this review, we describe the current state of the knowledge related to clinical manifestations, diagnosis, and chronic therapies for children with NMOSD, with emphasis on literature that has been published in the last 5 years. Following the review, we propose recommendations for the assessment/follow up clinical care, and treatment of this population.

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Section: Review Of Current Knowledgementioning

confidence: 99%

Pediatric NMOSD: A Review and Position Statement on Approach to Work-Up and Diagnosis

Tenembaum

Yeh

2020

Front. Pediatr.

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“…Cerebral lesions can result in focal neurologic deficits, depending on the location involved. Posterior reversible encephalopathy syndrome (PRES) and hydrocephalus resulting from inflammation and occlusion of cerebral aqueduct, have also been described (Baghbanian et al, 2018; Sand, 2016). Moreover, about half to two‐thirds of patients with NMOSD with brain lesions present cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

“…Myelitis in NMOSD is also frequently accompanied by neuropathic pain, pruritus, and paroxysmal tonic spasms (Chan, 2011; Rosales & Kister, 2016). Area postrema is a structure located in the dorsomedial part of the medulla oblongata (Baghbanian, Asgari, Sahraian, & Moghadasi, 2018). ⁠ An area postrema syndrome is characterized by intractable hiccups, nausea, and vomiting, and all these symptoms can occur together or separately (Han, Yang, Zhu, & Jin, 2017; Sand, 2016).…”

Section: Introductionmentioning

confidence: 99%

Cognitive impairment in NMOSD—More questions than answers

et al. 2020

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Since the first cases of neuromyelitis optica (NMO) had been described by Eugene Devic in 1894, the understanding of pathogenesis and clinical presentations of the disease broadened considerably (Wingerchuk et al., 2015). The discovery of an association of NMO with the presence of serum antibodies against aquaporin 4 (AQP4) facilitated the diagnostic process of the disease and allowed for better differentiation between NMO and multiple sclerosis (MS) variants. In the central nervous system (CNS), the water channel AQP4, involved in the processes of osmoregulation, is highly expressed on astrocytic end-feet (forming part of the blood-brain barrier)

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“…Current approach in treatment with rituximab is a stepup approach, which reserve rituximab for refractory cases (27). Due to this, some studies suggest rituximab as a first line maintenance therapy in pediatric NMOSDs (28,29).…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…Current practice in rituximab administration is a repeated fixed time infusion in every 6-12 months, but recently proposed approach suggests personalized treatment according to regular B-cell depletion and reconstitution monitoring (27,30). In conclusion, pediatric NMOSD is a rare but life threatening disease, which pediatrician and pediatric neurologists must be aware of its presentations and treatment.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Pediatric Neuromyelitis Optica Spectrum Disorders: Three Case Reports and Review of Literature

2020

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Introduction: Neuromyelitis optica spectrum disease (NMOSD) is a rare autoimmune inflammatory astrocytopathic demyelinating disease of the CNS. In the majority of patients, an autoantibody to the water channel protein aquaporin-4 (AQP4) would cause humoral inflammatory demyelination and axonal damage. The disease defined as clinical syndromes of optic nerve, area postrema, spinal cord, diencephalon, or cerebrum or MRI finding related to involvement of these regions. According to recent consensus diagnostic criteria, NMOSD categorized as NMOSD with AQP4 Ab, Also NMOSD without AQP4 Ab. Early onset is defined as the disease presentation before 17 years old. According to the pediatric NMOSD working group most clinical, laboratory characteristics and neuroimaging of this disease are the same as adult onset, and same criteria could be used for pediatric NMOSD. Differentiation of NMO from MS and acute disseminated encephalomyelitis (ADEM) are matters of importance in decision making in order to choose an appropriate therapy. It has also been reported that some MS therapies could aggravate NMO exacerbations and lead to permanent disability. Case Presentations: Three patients under the age of 17 years old were present in neurology clinic, due to their recurrent optic neuritis and cervical myelopathy. AQP4 Ab was positive in two patients, and the other patient was seronegative for AQP4 Ab. according to the recent international consensus definition. All of the patients went under treatment with corticosteroid pulse therapy in acute relapses, and two of them were getting azathioprine as a disease modifying therapy, and the other patient went under rituximab, because of new relapses in spite of azathioprine therapy. Azathioprine and rituximab were safe and tolerated well without any significant side effects in all of them. Conclusions: Pediatric NMOSD is a rare but life threatening disease, which pediatrician and pediatric neurologists must be aware of its presentations and treatment.

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A comparison of pediatric and adult neuromyelitis optica spectrum disorders: A review of clinical manifestation, diagnosis, and treatment

Cited by 30 publications

References 146 publications

Pediatric NMOSD: A Review and Position Statement on Approach to Work-Up and Diagnosis

Pediatric NMOSD: A Review and Position Statement on Approach to Work-Up and Diagnosis

Cognitive impairment in NMOSD—More questions than answers

Pediatric Neuromyelitis Optica Spectrum Disorders: Three Case Reports and Review of Literature

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