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Diagnostic Considerations in Acute Disseminated Encephalomyelitis and the Interface with MOG Antibody

Jonathan D Santoro1,2,3,4, Tanuja Chitnis1,2

  • 1Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States.

Neuropediatrics
|July 25, 2019
PubMed

Insights

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disorder presenting with encephalopathy and focal neurological deficits. Recognizing myelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases is crucial for accurate diagnosis and management.

Area of Science:

  • Neuroscience
  • Immunology
  • Pediatric Neurology

Background:

  • Acute disseminated encephalomyelitis (ADEM) is a clinically diverse neurological syndrome.
  • Distinguishing ADEM from other childhood demyelinating diseases requires careful evaluation.
  • Myelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases represent a newly identified category of disorders.

Purpose of the Study:

  • To review the clinical diagnosis and differential diagnosis of ADEM.
  • To discuss the interpretation of diagnostic data in ADEM.
  • To outline the treatment and prognosis of ADEM, focusing on MOG antibody spectrum.

Main Methods:

  • Literature review of ADEM and MOG antibody-associated diseases.
  • Analysis of clinical presentations, neuroimaging, and diagnostic criteria.
  • Synthesis of current understanding of MOG antibody spectrum and its relation to ADEM.

Main Results:

  • ADEM diagnosis is challenging due to its heterogeneity.
  • MOG antibody-associated diseases encompass ADEM and other phenotypes.
  • Understanding MOG antibodies is key to managing specific demyelinating conditions.

Conclusions:

  • Accurate diagnosis of ADEM relies on integrating historical, clinical, and neurodiagnostic information.
  • Myelin oligodendrocyte glycoprotein antibody testing is essential for identifying a subset of ADEM cases.
  • This review provides a comprehensive overview for clinicians managing ADEM and MOG-related disorders.

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