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Early predictors of epilepsy and subsequent relapse in children with acute disseminated (ADEM)

Hacohen, Y; Ciccarelli, O; (2019) Early predictors of epilepsy and subsequent relapse in children with acute disseminated (ADEM). Multiple Sclerosis Journal (In press).

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Abstract

Objective: To identify predictors of epilepsy and clinical relapses in children presenting with ADEM Methods: Children presenting with ADEM between 2005 and 2017 and tested clinically for MOG-Ab, were identified from three tertiary paediatric neurology centres in the UK. Patients were followed-up for a median of 6years (range 1-16 years). Results: 74 children were studied (38 females; median age at first presentation: 4.5 years (range: 1.4– 16). MOG-Ab was positive in 50/74(67.6%) of cases, and 27(54%) of MOG-Ab positive children presented with a neurological relapse over time. MOG-Ab was more frequently positive in the relapsing group than in the monophasic group (27/31 vs 23/43; odds ratio 5.9(95% CI 1.8-19.7); p=0.002). 16/74(22%) children had seizures during the acute presentation with ADEM and 12/74(16.2%) patients were diagnosed with post-ADEM epilepsy. The diagnosis of post-ADEM epilepsy was more frequently observed in children with relapsing disease than monophasic disease (10/31 vs 2/43; odds ratio 9.8 (95% CI: 2.0-48.7); p=0.003), positive intrathecal oligoclonal bands than those with negative bands (4/7 vs 4/30; odds ratio 8.7(95% CI: 1.4-54.0); p=0.027) and positive MOG-Ab than negative MOG-Ab cases (11/12 vs 39/62; odds ratio 6.5(95% CI:0.8-53.6); p=0.051). Conclusion: A higher relapse rate and a greater risk of post-ADEM epilepsy in children with MOG-Ab-associated disease may indicate a chronic disease with immune-mediate seizures in these children.

Type: Article
Title: Early predictors of epilepsy and subsequent relapse in children with acute disseminated (ADEM)
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation
URI: http://discovery.ucl.ac.uk/id/eprint/10065555
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