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Acta Med Port 2019 Feb 1;32(1):81-85. Epub 2019 Feb 1.

Departamento de Neurologia. Hospital da Luz. Lisboa. Portugal.

Acute disseminated encephalomyelitis is a rare inflammatory demyelinating multifocal disease of the central nervous system that typically occurs in children following vaccination or exanthematous viral infections and conveys an elevated risk of neurological sequelae unless promptly recognized and treated. We describe an adult case of acute disseminated encephalomyelitis following vaccination against Mumps, Measles and Rubella, presenting with fever and progressive neurological deficits which improved under systemic corticosteroid therapy. Considering the ongoing public debate regarding universal vaccination and the surge of previously controlled infectious diseases, we aim not only to underline the need for a rigorous assessment of vaccination safety on adult patients in order to prevent misguidance of public opinion, but also to alert clinicians for an early diagnosis of acute disseminated encephalomyelitis in these patients, the incidence of which we speculate may be rising. Read More

Mult Scler Relat Disord 2019 Jan 31;30:42-44. Epub 2019 Jan 31.

University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA; Children's Health, Dallas, TX, USA.

Importance: Patients afflicted with rare diseases often have a delay in diagnosis and treatment. Understanding the prevalence and impact of delayed diagnosis in transverse myelitis could trigger directed educational initiatives to increase clinician awareness and improve care.

Objective: To determine if symptoms at onset or care provider initially approached was associated with time to diagnosis, treatment or outcome in patients with transverse myelitis. Read More

Mult Scler 2019 Feb 7:1352458518823486. Epub 2019 Feb 7.

Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, UK; Department of Neuroinflammation, Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, London, UK.

Objective:: To identify predictors of epilepsy and clinical relapses in children presenting with acute disseminated encephalomyelitis (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 United Kingdom. Patients were followed up for a median of 6 years (range, 1-16 years). Read More

Neurology 2019 Feb 6. Epub 2019 Feb 6.

From the Oxford Autoimmune Neurology Group (P.J.W., M.W., S.R.I.), Nuffield Department of Clinical Neurosciences, UK; Institute for Experimental Immunology (L.K., S.L.), Affiliated to Euroimmun AG, Luebeck, Germany; and Departments of Neurology (M.M., E.P.F., A.C.K., A.M., S.J.P.) and Laboratory Medicine and Pathology (J.F., J.M., E.P.F., A.C.K., A.M., S.J.P.), Mayo Clinic, College of Medicine, Rochester, MN.

Objectives: To compares 3 different myelin oligodendrocyte glycoprotein-immunoglobulin G (IgG) cell-based assays (CBAs) from 3 international centers.

Methods: Serum samples from 394 patients were as follows: acute disseminated encephalomyelitis (28), seronegative neuromyelitis optica (27), optic neuritis (21 single, 2 relapsing), and longitudinally extensive (10 single, 3 recurrent). The control samples were from patients with multiple sclerosis (244), hypergammaglobulinemia (42), and other (17). Read More

Med Clin North Am 2019 Mar 3;103(2):325-336. Epub 2018 Dec 3.

Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Electronic address:

Autoimmune disorders of the central nervous system are common and often affect people in the most productive years of their lives. Among primary autoimmune diseases of the central nervous system, multiple sclerosis is most prevalent in the United States. Many other autoantibody-mediated neurologic syndromes have been identified within the past 2 to 3 decades, including neuromyelitis optica and anti-N-methyl-D aspartate receptor encephalitis. Read More

Neurol Neuroimmunol Neuroinflamm 2019 Mar 14;6(2):e528. Epub 2018 Dec 14.

Department of Neurology (Y.Y.M.W., C.L.d.M., R.M.v.d.V.d.V., E.D.v.P., I.A.K., R.Q.H.), MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands; and Department of Pediatric Neurology (C.E.C.-B., R.F.N.), Erasmus MC, Rotterdam, The Netherlands.

Objective: To compare the diagnostic accuracy of the McDonald 2017 vs the McDonald 2010 criteria to predict a second attack of MS (clinically definite MS [CDMS]) at the first attack of acquired demyelinating syndromes (ADS).

Methods: One hundred sixty-four children (aged <18 years) with an incident attack of ADS were included in a prospective multicenter study between June 2006 and December 2016. Brain (and spinal if available) MRI was performed ≤3 months after symptom onset. Read More

Front Neurol 2018 15;9:1156. Epub 2019 Jan 15.

Neurology Unit, Multiple Sclerosis Center, Department of Neuroscience of Bambino Gesù Children's Hospital, Rome, Italy.

The aim of the study was to estimate the rate of evolution or for multiple sclerosis (MS), after a first acute demyelinating event (ADE) in pediatric patients, and to investigate the variables that predict this evolution. We retrospectively evaluated the clinical and neuroradiological features of children who presented a first ADE between January 2005 and April 2017. All patients included underwent a baseline MRI, a cerebrospinal fluid and blood analysis, including virological examinations. Read More

Noro Psikiyatr Ars 2018 ;55(Suppl 1):S1-S9

Department of Neurology, İstanbul Bağcılar Research and Training Hospital, İstanbul, Turkey.

The diagnostic criteria for multiple sclerosis (MS) have been continuously evolved since 1950's, and gained speed parallel to the development of detailed laboratory methods. The common aim for all the defined criteria up to now, is to establish the dissemination in space and time of the clinical picture caused by the lesions in the central nervous system (CNS), and to rule out other diseases which might mimic MS. There is no definite measure or laboratory marker for the diagnosis of MS, yet. Read More

Asian J Transfus Sci 2018 Jul-Dec;12(2):127-135

Department of Paediatrics, Apollo Children's Hospitals, Chennai, Tamil Nadu, India.

Introduction: Outcome data in pediatric plasma exchange, especially in nonrenal indications are scarce. We aimed to evaluate its role and outcome in our patients.

Subjects And Methods: A retrospective study of children admitted in the year 2016 to the Pediatric Intensive Care Unit requiring plasma exchange for nonrenal indications was undertaken. Read More

Vaccine 2019 Feb 23;37(8):1126-1129. Epub 2019 Jan 23.

Division of Basic Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan.

While the basic definition of vaccination-associated acute disseminated encephalomyelitis (ADEM) is relatively clear and easily understandable, it is often difficult to diagnose ADEM based on clinical findings alone. ADEM is actually a heterogeneous clinical syndrome that can be approximately characterized by encephalomyelitis with multiple inflammatory demyelination, autoimmune causes, and relationship with a preceding infection or vaccination. The differential diagnosis of ADEM should exclude the possibility of infectious or other autoimmune encephalitis. Read More

Trop Doct 2019 Jan 24:49475518825219. Epub 2019 Jan 24.

5 Professor, Department of Microbiology, PGIMER and DR. R.M.L. Hospital, New Delhi, India.

Chikungunya (CHIK) has re-emerged as a potential neurotropic virus, with outbreaks recently being reported from many parts of India. The present study was conducted to study the spectrum and outcome of neurological complications in patients of CHIK during the 2016 outbreak in Delhi. A total of 42 cases seropositive for IgM CHIK antibodies by MAC-ELISA and developing neurological complications were enrolled. Read More

Jpn J Radiol 2019 Jan 22. Epub 2019 Jan 22.

Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo Prefecture, Japan.

Purpose: To evaluate the frequency, characteristics, and clinical significance of transient hyperintensity foci on T1-weighted images (T1WI) in acute disseminated encephalomyelitis (ADEM).

Materials And Methods: Patients diagnosed with ADEM underwent MR studies at the time of disease onset and every 3 months or more often thereafter. The frequency and appearance timing of abnormal signals including T1WI and their morphological characteristics were evaluated. Read More

MBio 2019 Jan 22;10(1). Epub 2019 Jan 22.

Pathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, Arizona, USA

Enteroviruses are a common cause of respiratory and gastrointestinal illness, and multiple subtypes, including poliovirus, can cause neurologic disease. In recent years, enterovirus D68 (EV-D68) has been associated with serious neurologic illnesses, including acute flaccid myelitis (AFM), frequently preceded by respiratory disease. A cluster of 11 suspect cases of pediatric AFM was identified in September 2016 in Phoenix, AZ. Read More

Clin Case Rep 2019 Jan 28;7(1):160-163. Epub 2018 Nov 28.

Department of Pediatrics University of Kansas Medical Center Kansas City Kansas.

Intravenous immunoglobulin therapy should be considered in pediatric acute hemorrhagic leukoencephalitis that is refractory to steroid and plasmapheresis. Read More

Rinsho Ketsueki 2018 ;59(12):2588-2593

Hematology, Graduate School of Medicine, Osaka City University.

Chronic graft versus host disease (cGVHD) of the central nervous system is a rare condition that could occur after allogeneic hematopoietic stem cell transplantation (SCT) but has been poorly documented. Here, we report a patient diagnosed with recurrent acute disseminated encephalomyelitis (ADEM) with longitudinal extensive transverse myelitis (LETM) as cGVHD after HLA haploidentical peripheral blood SCT using posttransplantation cyclophosphamide for mixed-phenotype acute leukemia. We observed clinical and radiological improvement after the rituximab treatment of the condition that had been refractory to steroids. Read More

Case Rep Neurol Med 2018 28;2018:8409247. Epub 2018 Nov 28.

Ege University, Faculty of Medicine, Department of Radiology, Izmir, Turkey.

Demyelinating lesions larger than 2 cm in diameter, with or without edema, are known as tumefactive demyelinating lesions (TDLs). They constitute a rare inflammatory demyelinating disorder of the central nervous system. TDLs are typically characterized by headaches, cortical symptoms such as aphasia, hemiparesis, hemisensory deficits, seizures, and changes in consciousness. Read More

eNeurologicalSci 2019 Mar 22;14:40-42. Epub 2018 Nov 22.

The London Clinic, London, UK.

Acute disseminated encephalomyelitis (ADEM) is an uncommon, autoimmune, demyelinating disorder of of the central nervous system. It is rare in adults beyond 65 years. Here, we describe a novel presentation following urological surgery. Read More

Rinsho Shinkeigaku 2019 Jan 29;59(1):33-36. Epub 2018 Dec 29.

Department of Neurology, Fujita Health University, School of Medicine.

A 48-year-old man with rapid onset of fever elevation developed acute myelitis over a period of a week. MRI of the spinal cord revealed a longitudinal T-hyperintense intraspinal lesion extending from C6 to Th8 level. Clinical symptoms and findings resolved with immunotherapy. Read More

BMJ Case Rep 2018 Dec 27;11(1). Epub 2018 Dec 27.

Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory-demyelinating disease of central nervous system. Several viral infections and vaccines act as precipitating factor for ADEM. We report an 8-year-old girl presenting with acute-onset flaccid paraparesis and bilateral painless vision loss. Read More

Mult Scler Relat Disord 2018 Dec 18;28:109-116. Epub 2018 Dec 18.

MS Center and National Reference Center of adult Leukodystrophies, Department of Neurology, Montpellier University Hospital, 34 295 Montpellier Cedex 5, France. Electronic address:

Background: The recent 2017 modification have increased the sensitivity of McDonald criteria for MS. Nevertheless, some MS patients with atypical MRI findings have been identified, leading to prolonged delay to diagnosis and high costs to look for alternative diagnoses.

Objective: To describe a series of MS patients with atypical MRI presentation. Read More

Mult Scler Relat Disord 2018 Dec 14;28:101-103. Epub 2018 Dec 14.

Mersin University, Faculty of Medicine, Department of Pediatric Neurology, Mersin, Turkey. Electronic address:

Background: Myelin Oligodendrocyte Glycoprotein antibodies (MOG) may be used as a biomarker for diagnosis of many demyelinating diseases. Especially, patients of acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), aquaporin-4 (AQP4) seronegative neuromyelitis optica spectrum disorder (NMOSD), monophasic or recurrent optic neuritis (ON), transverse myelitis and N-methyl-d-aspartate (NMDA) receptor encephalitis (NMDARe) can overlap with Myelin Oligodendrocyte Glycoprotein antibodies. We present a child with autoimmune encephalitis in whom antibodies against Myelin Oligodendrocyte Glycoprotein (MOG) and N-methyl-d-aspartate receptor (NMDAR) were simultaneously detected. Read More

JAMA Neurol 2018 Dec 21. Epub 2018 Dec 21.

Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.

Importance: Recognizing the characteristics of myelin oligodendrocyte glycoprotein autoantibody (MOG-IgG) myelitis is essential for early accurate diagnosis and treatment.

Objective: To evaluate the clinical, radiologic, and prognostic features of MOG-IgG myelitis and compare with myelitis with aquaporin-4-IgG (AQP4-IgG) and multiple sclerosis (MS).

Design, Setting, And Participants: We retrospectively identified 199 MOG-IgG-positive Mayo Clinic patients from January 1, 2000, through December 31, 2017, through our neuroimmunology laboratory. Read More

Nat Rev Neurol 2019 Feb;15(2):89-102

Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.

Anti-myelin oligodendrocyte glycoprotein (MOG) antibodies (MOG-Abs) were first detected by immunoblot and enzyme-linked immunosorbent assay nearly 30 years ago, but their association with multiple sclerosis (MS) was not specific. Use of cell-based assays with native MOG as the substrate enabled identification of a group of MOG-Ab-positive patients with demyelinating phenotypes. Initially, MOG-Abs were reported in children with acute disseminated encephalomyelitis (ADEM). Read More

Front Immunol 2018 29;9:2753. Epub 2018 Nov 29.

Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.

Inflammatory demyelinating CNS syndromes include, besides their most common entity multiple sclerosis (MS), several different diseases of either monophasic or recurrent character-including neuromyelitis optica spectrum disorders (NMOSDs) and acute disseminated encephalomyelitis (ADEM). Early diagnostic differentiation is crucial for devising individual treatment strategies. However, due to overlapping clinical and paraclinical features diagnosis at the first demyelinating event is not always possible. Read More

Brain Dev 2018 Dec 3. Epub 2018 Dec 3.

Department of Pediatrics, St Mary's Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan; Research Centre for Children and Research Centre for Rett Syndrome, St Mary's Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan. Electronic address:

Acute disseminated encephalomyelitis (ADEM) is a typically monophasic inflammatory demyelinating disease of the central nervous system with a favorable outcome. However, 2% of ADEM involves acute hemorrhagic leukoencephalitis (AHLE), which is a fulminant and hyperacute variant of ADEM with a poor outcome and high mortality. There are limited case reports of fulminant ADEM including AHLE in children. Read More

J Pediatr 2018 Dec 6. Epub 2018 Dec 6.

Department of Pediatrics, Tulane University, New Orleans, LA; Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX.

Objective: To determine the temporal trends in the epidemiology of acute disseminated encephalomyelitis (ADEM) and hospitalization outcomes in the US from 2006 through 2014.

Study Design: Pediatric (≤18 years of age) hospitalizations with ADEM discharge diagnosis were identified from the National (Nationwide) Inpatient Sample (NIS) for years 2006 through 2014. Trends in the incidence of ADEM with respect to age, sex, race, and region were examined. Read More

Vaccine 2019 Jan 30;37(2):366-371. Epub 2018 Nov 30.

Kitasato Institute for Life Sciences, Laboratory of Viral Infection, 5-9-１ Shirokane Minato-ku, Tokyo 108-8641, Japan. Electronic address:

Vaccine adverse events and controversial safety issues have occurred in recent decades in Japan: aseptic meningitis following the measles-mumps-rubella combined vaccine (MMR), anaphylaxis after immunization with live virus vaccines and inactivated split influenza vaccine, an increased incidence of febrile illness following the simultaneous administration of inactivated vaccines, and chronic pain with neurological illness after immunization with the human papilloma virus vaccine (HPV). Vaccine adverse events are a matter of concern for the public as well as general practitioners; some are within the range of assumptions that adverse reactions after live attenuated vaccines are related to the nature of their parental wild-type viruses. Vaccines stimulate the innate immunity of host immunological defense mechanisms and induce the development of specific acquired immunity. Read More

Cureus 2018 Sep 24;10(9):e3351. Epub 2018 Sep 24.

Orthopaedics, Dow University of Health Sciences, Karachi, PAK.

Variegate porphyria (VP) is one of the groups of rare inherited disorders of hemoglobin synthesis called Porphyria. It has two distinct manifestations, that is, those of cutaneous and nervous system. Posterior reversible encephalopathy syndrome (PRES) is a rare complication of porphyria. Read More

J Child Neurol 2018 Nov 27:883073818811541. Epub 2018 Nov 27.

2 Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.

Objective:: To assess the intracranial pressure in pediatric acute disseminated encephalomyelitis using spinal tap opening pressure on lumbar puncture, which is routinely performed as part of suspected acute disseminated encephalomyelitis workup. Compared to other cerebrospinal fluid parameters such as cell count, protein concentration, and presence of oligoclonal bands, cerebrospinal fluid opening pressure is infrequently recorded.

Methods:: A retrospective chart review of demographic, clinical, and laboratory data of children diagnosed with acute disseminated encephalomyelitis admitted to a tertiary referral hospital between 2005 and 2016. Read More

Can J Neurol Sci 2018 Nov;45(6):686-687

1Division of Neurology,Department of Medicine,University of Toronto,Toronto,Ontario,Canada.

J Pediatr 2019 Feb 6;205:130-137. Epub 2018 Nov 6.

Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address:

Objective: To characterize the spectrum and salient clinical features of adenovirus-associated neurologic disease in immunocompetent children.

Study Design: Previously healthy children (aged 1 month-18 years) with central nervous system (CNS) disease associated with adenovirus infection were identified via the Encephalitis Registry (1996-2016) and Microbiology Database (2000-2016) at The Hospital for Sick Children, Toronto, and by systematic review of the literature. The data were pooled and analyzed to identify the spectrum of illness, clinical outcome, and risk factors for death or neurologic impairment. Read More

Pediatr Neurol 2018 Dec 21;89:49-57. Epub 2018 Sep 21.

Government Medical College Trivandrum, Kerala, India.

Objective: We studied the long-term outcome of Acute disseminated encephalomyelitis (ADEM).

Methods: We performed a retrospective cohort study among children diagnosed with ADEM (fulfilling IPMSSG criteria). Major outcome variables were motor deficit, scholastic underperformance, and behavioral abnormality. Read More

Mult Scler Relat Disord 2018 10;25:A1-A2

J Neuroinflammation 2018 Oct 31;15(1):302. Epub 2018 Oct 31.

Department of Neurology, College of Medicine, Seoul National University, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.

Background: Key clinical features of chronic relapsing inflammatory optic neuropathy (CRION) include relapsing inflammatory optic neuritis (ON) and steroid dependency, both of which have been reported among patients with myelin oligodendrocyte glycoprotein antibodies (MOG-Abs). We investigated the relevance of the presence of serum MOG-IgG with the current diagnostic criteria for CRION among patients with idiopathic inflammatory optic neuritis (iON).

Methods: Retrospective reviews of a database prospectively collated between 2011 and 2017 from the tertiary referral center for multiple sclerosis and neuromyelitis optica were performed. Read More

Mem Inst Oswaldo Cruz 2018 Oct 29;113(11):e170538. Epub 2018 Oct 29.

Instituto Evandro Chagas, Seção de Arbovirologia e Febres Hemorrágicas, Ananindeua, PA, Brasil.

This study showed that laboratory markers of recent infection by dengue, Zika or chikungunya arboviruses were detected in the biological samples of approximately one-third of patients with encephalitis, myelitis, encephalomyelitis or Guillain-Barré syndrome, in a surveillance programme in Piauí state, Brazil, between 2015-2016. Fever and myalgia had been associated with these cases. Since in non-tropical countries most infections or parainfectious diseases associated with the nervous system are attributed to herpesviruses, enteroviruses, and Campylobacter jejuni, the present findings indicate that in tropical countries, arboviruses may now play a more important role and reinforce the need for their surveillance and systematic investigation in the tropics. Read More

Malar J 2018 Oct 26;17(1):387. Epub 2018 Oct 26.

Infectious and Tropical Diseases Unit, APHP, Pitié Salpêtrière Hospital, 75013, Paris, France.

Background: Post-malaria neurological syndrome (PMNS) is a debated entity, defined by neurological complications following a post-malaria symptom-free period and a negative blood smear. Four cases of PMNS are hereby reported and a review the literature performed to clarify the nosological framework of this syndrome.

Methods: A French teaching hospital infectious diseases database was investigated for all PMNS cases occurring between 1999 and 2016 and the PubMed database for cases reported by other institutions after 1997. Read More

Neurol Clin 2018 Nov 20;36(4):705-724. Epub 2018 Sep 20.

Division of Neuroimmunology and Neuroinfectious Diseases, Department of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD 21287, USA.

Viruses are a frequent cause of encephalitis. Common or important viruses causing encephalitis include herpesviruses, arboviruses, enteroviruses, parechoviruses, mumps, measles, rabies, Ebola, lymphocytic choriomeningitis virus, and henipaviruses. Other viruses may cause an encephalopathy. Read More

Neurochem Int 2018 Oct 23. Epub 2018 Oct 23.

Department of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan. Electronic address:

Immunoglobulin G (IgG) antibodies against myelin oligodendrocyte glycoprotein (MOG) are detected in the serum of some patients with demyelinating diseases. These patients are known to show repeated clinical episodes of inflammatory demyelinating attacks in the central nervous system. Although the associated pathogenicity and mechanism of inflammatory demyelination remains inconclusive, it is known that patients with MOG-IgG antibodies have a different clinical spectrum from those with other demyelinating diseases, such as multiple sclerosis. Read More

Med Clin (Barc) 2018 Oct 15. Epub 2018 Oct 15.

Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España.

Clin Neurol Neurosurg 2018 Dec 9;175:47-49. Epub 2018 Oct 9.

Departmenf of Neurology, Hospital de Galdakao-Usansolo, 48960 Galdacano, Vizcaya, Spain. Electronic address:

Front Psychiatry 2018 25;9:451. Epub 2018 Sep 25.

Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China.

Autoimmune diseases of the nervous system (ADNS) consist of a group of severely disabling disorders characterized by abnormal immune attack against protein components of the nervous system. This type of attack behavior may occur in the central or peripheral nervous system, and in the neuromuscular junction, resulting in neuronal damage, axonal injury, demyelination or destruction of the neuromuscular junction. While the neurological deficits of patients with ADNS have received significant research attention, the manifestation of depression tends to be ignored. Read More

Pediatr Neurol 2018 Nov 10;88:31-35. Epub 2018 Aug 10.

Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address:

Background: Pediatric stroke alerts or "code strokes" allow for rapid evaluation, imaging, and treatment of children presenting with stroke-like symptoms. In a previous study of emergency department-initiated pediatric stroke alerts, 24% of children had confirmed strokes. The purpose of this study was to characterize in-hospital pediatric stroke alerts. Read More

Mult Scler Relat Disord 2019 Jan 3;27:30-33. Epub 2018 Oct 3.

UT Southwestern Medical Center, 5323 Harry Hines Blvd Dallas, Texas, TX 75235, United States.

Objective: To describe 2 atypical cases with Anti-MOG antibody related demyelinating syndrome.

Methodology: Case series.

Results: We present two cases. Read More

J Neurol Sci 2018 Dec 26;395:47-53. Epub 2018 Sep 26.

Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia. Electronic address:

We review post-infectious and post-vaccination neurological syndromes involving peripheral and central nervous system (CNS) and report an illustrative case of simultaneous occurrence of Guillain-Barré syndrome (GBS), confirmed by nerve conduction velocities, plus MRI-demonstrated transverse myelitis (TM) and acute encephalitis [acute disseminated encephalomyelitis] (ADEM+GBS) affecting a 24-year-old woman from Cúcuta, Colombia, who developed acute Zika virus (ZIKV) infection confirmed by serum reverse transcriptase-polymerase chain reaction (RT-PCR) and convalescent ZIKV IgG antibodies. With intensive care treatment, respiratory support, steroids, and intravenous immunoglobulin (IVIg), patient survived with residual flaccid paraparesis. She had preexisting immunity against Chikungunya virus (CHIKV) and Dengue virus (DENV) acquired before the arrival of ZIKV in Colombia. Read More

Brain Behav 2018 Nov 3;8(11):e01129. Epub 2018 Oct 3.

Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Objectives: Neuromyelitis optica (NMO) is frequently associated with aquaporin-4 autoantibodies (AQP4-Ab); however, studies of NMO in Lithuania are lacking. Therefore, the main objective of our study is to assess positivity for AQP4-Ab in patients presenting with inflammatory demyelinating central nervous system (CNS) diseases other than typical multiple sclerosis (MS) in Lithuania.

Materials And Methods: Data were collected from the two largest University hospitals in Lithuania. Read More

Rev Neurol (Paris) 2018 Sep 27. Epub 2018 Sep 27.

Service de médecine interne et spécialités médicales, Hôpital National de Niamey, BP 238, Niamey, Niger; Faculté des sciences de la santé, Université Abdou Moumouni de Niamey, Niamey, Niger.

Background: In sub-Saharan Africa (SSA), few studies have been reported on inflammatory demyelinating diseases of the central nervous system (CNS). Neuromyelitis optica spectrum disorders (NMOSD) seems to be the most frequent inflammatory demyelinating disease of CNS in sub-Saharan Africans or people of sub-Saharan African descent.

Methods: We report the observations of seven patients from Niger diagnosed with inflammatory demyelinating diseases of CNS over a period of 21 years (1996-2017). Read More

Nervenarzt 2018 Dec;89(12):1388-1399

AG Molekulare Neuroimmunologie, Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.

Over the past few years, new-generation cell-based assays have demonstrated a robust association of autoantibodies to full-length human myelin oligodendrocyte glycoprotein (MOG-IgG) with (mostly recurrent) optic neuritis, myelitis and brainstem encephalitis, as well as with acute disseminated encephalomyelitis (ADEM)-like presentations. Most experts now consider MOG-IgG-associated encephalomyelitis (MOG-EM) a disease entity in its own right, immunopathogenetically distinct from both classic multiple sclerosis (MS) and aquaporin-4 (AQP4)-IgG-positive neuromyelitis optica spectrum disorders (NMOSD). Owing to a substantial overlap in clinicoradiological presentation, MOG-EM was often unwittingly misdiagnosed as MS in the past. Read More

Clin Infect Dis 2018 Sep 24. Epub 2018 Sep 24.

Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Background: Japanese encephalitis (JE) is the leading cause of viral encephalitis with high mortality and morbidity in Asia. In Japan, however, the active recommendation of JE vaccine was retracted in 2005 because of the potential risk of acute disseminated encephalomyelitis. We aimed to determine the recent incidence of childhood-onset JE after the domestic change of vaccination policy in Japan, and to analyze the clinical features of affected children. Read More

Mult Scler Relat Disord 2018 Nov 11;26:86-89. Epub 2018 Sep 11.

Duke University, Durham, NC, United States.

Background: Acute disseminated encephalomyelitis has been understood as a monophasic, often post-infectious illness that predominantly affects the pediatric population. Though that describes the majority of cases, exceptions do exist. In this case report, we present an adult case of recurrent disseminated encephalomyelitis (DEM) and review the available literature on this clinical entity. Read More

Radiologe 2018 Dec;58(12):1080-1090

Abteilung für Neuroradiologie, Kantonsspital Baden, Baden, Schweiz.

Clinical Issue: Autoimmune disorders of the central nervous system (CNS) are common but are also a heterogeneous group of diseases. The most common form is multiple sclerosis (MS), others are clinically isolated syndrome (CIS), acute demyelinating encephalomyelitis (ADEM) and neuromyelitis optica spectrum disorders (NMOSD). Paraneoplastic syndromes are rare and tumor-associated, they are not induced by direct invasion of tumor tissue but by tumor-associated autoantibodies mostly against specific CNS proteins, e. Read More