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Myelin Oligodendrocyte Glycoprotein MOG35-55 Induced Experimental Autoimmune Encephalomyelitis EAE in C57BL/6 Mice
Published on: April 15, 2014
Pediatric MOG-Ab-Associated Encephalitis: Supporting Early Recognition and Treatment.
Nee Na Kim1, Dimitrios Champsas1, Michael Eyre1
1From the Department of Neurology (N.N.K., O.A.-M., Y.H.), Great Ormond Street Hospital for Children NHS Foundation Trust; Department of Neuroinflammation (N.N.K., D.C., O.A.-M., C.H., O.C., Y.H.), Institute of Neurology, University College London; Children's Neurosciences (M.E., V.L., M.L., T.R.), Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust; Department of Women and Children's Health (M.E., M.L., T.R.), School of Life Course Sciences (SoLCS), King's College London; Department of Paediatrics (A.S., S.R., J.P.), Children's Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust; Department of Paediatric Neurology (M.V.C.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust; Translational and Clinical Research Sir James Spence Institute (R.F.), University of Newcastle, Royal Victoria Infirmary; Department of Neurology (R.F.), Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust; Department of Neurology (R.K.), Alder Hey Children's Hospital, Alder Hey Children's NHS Foundation Trust, Liverpool; Department of Paediatric Neurology (D.R., Siobhan West), Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust; Department of Neurology (E.W., Sukhvir Wright), Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust; Department of Neuroradiology (A.B., K.M.), Great Ormond Street Hospital, Great Ormond Street Hospital Trust, London, United Kingdom; Department of Neurology (E.P.F.), Laboratory Medicine and Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Rochester, MN; NIHR University College London Hospitals Biomedical Research Centre (O.C.); and Department of Neuroinflammation (O.C.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, United Kingdom.
Myelin oligodendrocyte glycoprotein antibody (MOG-Ab) encephalitis in children presents differently than acute disseminated encephalomyelitis (ADEM). Early immunosuppression is crucial, even with normal MRI, for MOG-Ab positive cases.
Area of Science:
- Neurology
- Immunology
- Pediatrics
Background:
- Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) are implicated in encephalitis beyond acute disseminated encephalomyelitis (ADEM).
- Understanding MOG-Ab encephalitis in children is crucial for accurate diagnosis and management.
Purpose of the Study:
- To evaluate a cohort of children with MOG-Ab encephalitis not meeting ADEM criteria.
- To compare their clinical and paraclinical features with children diagnosed with ADEM.
Main Methods:
- Retrospective, multicenter cohort study of pediatric patients (<18 years) with MOG-Ab.
- Stratification into encephalitis phenotype (not ADEM) and ADEM groups.
- Statistical comparison using Mann-Whitney U test and Chi-squared/Fisher exact test.
Main Results:
- 33 children had MOG-Ab encephalitis and 74 had ADEM.
- Encephalitis symptoms included headache (88%), seizures (73%), and fever (67%).
- Children with encephalitis were older, more likely to need intensive care, received steroids later, and had higher rates of epilepsy at follow-up compared to ADEM patients.
Conclusions:
- MOG-Ab testing is recommended for all suspected encephalitis cases, including those with normal brain MRI.
- Negative infection markers in immunocompetent children should not delay immunosuppressive treatment for suspected immune-mediated disease.
- Early initiation of immunosuppression (steroids, IVIG, plasma exchange) is vital while awaiting MOG-Ab results.
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