Acquired demyelinating disorders of the central nervous system in a sample of Egyptian children

Abstract

Acquired demyelinating syndrome (ADS) is a group of inflammatory immune-mediated attacks on the central nervous system's (CNS) myelin sheath, presenting as optic neuritis or transverse myelitis. The study aimed to studying ADS in children is growing, with implications for better management and outcome. This is a cross-sectional study analyzing patients with neuro-immune diseases at Al-Azhar University hospitals under 18 years old with CNS inflammatory demyelination. They undergo comprehensive medical and neurological examinations, with follow-up data collected at six-months post-onset. Diagnosis requires AQP4 antibody, clinical criteria, and additional magnetic resonance imaging (MRI) requirements. The study included 59 patients with ADS; 46 % were diagnosed with acute disseminated encephalomyelitis (ADEM), 14 % had clinically isolated syndrome (CIS), 14 % had myelin oligodendrocyte glycoprotein antibody disease (MOGAD), 20 % had multiple sclerosis (MS), and 6.8 % had neuromyelitis optica spectrum disorder (NMOSD). Most participants were urban residents. Clinical presentation showed encephalopathy in 55.9 % of participants, with ADEM having the highest prevalence (93 %). Motor symptoms were prevalent in 84.7 %, with sensory symptoms highest in the NMOSD group. Cerebellar symptoms were reported by 52 %, with ADEM having the highest rate (74 %). 20.3 % of cases had brain abnormalities on MRI scans, with no significant difference between groups. In conclusion this study provides detailed information on pediatric ADS (PADS) patients in Egypt, a developing country lacking research coverage. It investigates clinical profiles, laboratory findings, treatment, and prognosis. However, limitations include a single center experience, potential information bias, and short follow-up duration, highlighting the need for more longitudinal multicenter studies.