Anti-Myelin Oligodendrocyte Glycoprotein Antibody Associated With Gray Matter Predominant Transverse Myelitis Mimicking Acute Flaccid Myelitis: A Presentation of Two Cases

Wang, Cynthia; Narayan, Ram; Greenberg, Benjamin

doi:10.1016/j.pediatrneurol.2018.06.003

Cited by 22 publications

(13 citation statements)

References 13 publications

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“…The “H-sign” is suggestive, but not specific for MOGAD, reported in 29% of patients with MOG-TM and 8% of patients with NMO-TM ( 40 ). The predilection for the gray matter may explain why MOG-TM sometimes presents as acute flaccid paralysis (AFM) ( 45 ): in one series 10 out of 47 MOGAD patients (21%) met clinical criteria for AFM ( 40 ).…”

Section: Transverse Myelitismentioning

confidence: 99%

The Expanding Clinical Spectrum of Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Associated Disease in Children and Adults

Parrotta¹,

Kister

2020

Front. Neurol.

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Section: Transverse Myelitismentioning

confidence: 99%

The Expanding Clinical Spectrum of Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Associated Disease in Children and Adults

Parrotta¹,

Kister

2020

Front. Neurol.

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“…NMO is associated with AQP4 antibodies in the CSF and spinal cord lesions with more white matter involvement than seen in AFM. Anti-MOG associated demyelination can also mimic AFM radiographically when the spinal cord is involved 30. Clinically and diagnostically, however, patients with anti-MOG disease have preserved and often brisk reflexes, more prominent sensory findings and marked clinical improvement with immunomodulatory therapies.…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Update on acute flaccid myelitis: recognition, reporting, aetiology and outcomes

Hardy

Hopkins

2020

Arch Dis Child

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Acute flaccid myelitis, defined by acute flaccid limb weakness in the setting of grey matter lesions of the spinal cord, became increasingly recognised in 2014 following outbreaks in Colorado and California, temporally associated with an outbreak of enterovirus D68 respiratory disease. Since then, there have been biennial increases in late summer/early fall. A viral infectious aetiology, most likely enteroviral, is strongly suspected, but a definitive connection has yet to be established. Patients typically present with asymmetric weakness, maximal proximally, in the setting of a febrile illness. MRI demonstrates T2/FLAIR abnormalities in the central grey matter of the spinal cord, and cerebrospinal fluid typically shows a lymphocytic pleocytosis with variable elevation in protein. The weakness may be progressive over several days and involve respiratory muscles, making early recognition and close monitoring essential. Other complications in the acute period may include autonomic instability and bowel/bladder involvement. There is no clear recommended treatment at this time, although intravenous immunoglobulin, steroids and plasma exchange have been used. Intensive therapies and rehab services have shown benefit in maximising function, and surgical interventions may be considered in cases without optimal response to therapies. Close attention should also be paid to psychosocial factors. Prognosis is generally guarded, and additional factors that predict final outcome, including host factors and treatment effects, have yet to be elucidated. Multicentre collaborative efforts will be required to provide answers about this rare but serious disorder.

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“…During the 2014 investigation it was noted that, in addition to the clinical similarities among the cases, the spinal cord MR imaging had consistent features, including longitudinal signal hyperintensities in the anterior spinal cord gray matter on T2-weighted images [7,8].…”

Section: Introductionmentioning

confidence: 98%

“…Also, longitudinally extensive lesions that primarily involve the gray matter but may not be confined to the anterior horn cells, may be seen early in the course of AFM [7,8]. These features were also critical in distinguishing AFM from other causes of acute flaccid paralysis.…”

Section: Introductionmentioning

confidence: 99%

A ten-year retrospective evaluation of acute flaccid myelitis at 5 pediatric centers in the United States, 2005–2014

Cortese¹,

Kambhampati²,

Schuster³

et al. 2020

PLoS ONE

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Background Acute flaccid myelitis (AFM) is a severe illness similar to paralytic poliomyelitis. It is unclear how frequently AFM occurred in U.S. children after poliovirus elimination. In 2014, an AFM cluster was identified in Colorado, prompting passive US surveillance that yielded 120 AFM cases of unconfirmed etiology. Subsequently, increased reports were received in 2016 and 2018. To help inform investigations on causality of the recent AFM outbreaks, our objective was to determine how frequently AFM had occurred before 2014, and if 2014 cases had different characteristics.

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Anti-Myelin Oligodendrocyte Glycoprotein Antibody Associated With Gray Matter Predominant Transverse Myelitis Mimicking Acute Flaccid Myelitis: A Presentation of Two Cases

Cited by 22 publications

References 13 publications

The Expanding Clinical Spectrum of Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Associated Disease in Children and Adults

The Expanding Clinical Spectrum of Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Associated Disease in Children and Adults

Update on acute flaccid myelitis: recognition, reporting, aetiology and outcomes

A ten-year retrospective evaluation of acute flaccid myelitis at 5 pediatric centers in the United States, 2005–2014

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