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Imaging in Pediatric Demyelinating and Inflammatory Diseases of Brain- Part 2

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Abstract

Imaging plays an important role in diagnosis, management, prognostication and follow up of pediatric demyelinating and inflammatory diseases of brain and forms an integral part of the diagnostic criteria. This article reviews the spectrum of aquaporinopathies with an in-depth discussion on present criteria and differentiation from other demyelinating diseases with clinical vignettes for illustration; the latter part of article deals with the spectrum of CNS vasculitis.

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References

  1. Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015;85:177–89.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lennon VA, Wingerchuk DM, Kryzer TJ, et al. A serum antibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet. 2004;364:2106–12.

    Article  CAS  PubMed  Google Scholar 

  3. Makhani N, Bigi S, Banwell B, Shroff M. Diagnosing neuromyelitis optica. Neuroimaging Clin N Am. 2013;23:279–91.

    Article  PubMed  Google Scholar 

  4. Wingerchuk DM, Lennon VA, Pittock SJ, et al. Revised diagnostic criteria for neuromyelitis optica. Neurology. 2006;66:1485–9.

    Article  CAS  PubMed  Google Scholar 

  5. Wingerchuk D, Banwell B, Bennett J. Revised diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2014;82:S63.001.

    Google Scholar 

  6. Kim W, Kim S-H, Huh S-Y. Brain abnormalities in neuromyelitis optica spectrum disorder. Multiple Sclerosis International. 2012;2012:Article ID 735486.

  7. Evangelopoulos ME, Koutsis G, Andreadou E, Potagas C, Dimirakopoulos A, Sfagos C. Neuromyelitis optica spectrum disease with positive autoimmune indices: a case report and review of the literature. Case Rep Med. 2011;2011:Article ID 393568.

  8. Leite MI, Coutinho E, Lana-Peixoto M, et al. Myasthenia gravis and neuromyelitis optica spectrum disorder: a multicenter study of 16 patients. Neurology. 2012;78:1601–7.

  9. Kim HJ, Paul F, Lana-Peixoto MA, et al. MRI characteristics of neuromyelitis optica spectrum disorder- an international update. Neurology. 2015;84:1165–73.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Banwell B, Tenembaum S, Lennon VA, et al. Neuromyelitis optica-IgG in childhood inflammatory demyelinating CNS disorders. Neurology. 2008;70:344–52.

    Article  CAS  PubMed  Google Scholar 

  11. Trebst C, Raab P, Voss EV, et al. Longitudinal extensive transverse myelitis-it’s not all neuromyelitis optica. Nat Rev Neurol. 2011;7:688–98.

    Article  CAS  PubMed  Google Scholar 

  12. Flanagan EP, Weinshenker BG, Krecke KN, et al. Short myelitis lesions in aquaporin-4-IgG-positive neuromyelitis optica spectrum disorders. JAMA Neurol. 2015;72:81–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Doring TM, Lopes FCR, Kubo TTA, et al. Neuromyelitis optica: a diffusional kurtosis imaging study. AJNR Am J Neuroradiol. 2014;35:2287–92.

    Article  CAS  PubMed  Google Scholar 

  14. Kim HJ, Paul F, Lana-Peixoto MA, et al; Guthy-Jackson Charitable Foundation NMO International Clinical Consortium & Biorepository. MRI characteristics of neuromyelitis optica spectrum disorder: an international update. Neurology. 2015;84:1165–73.

  15. Ito S, Mori M, Makino T, Hayakawa S, Kuwabara S. “Cloud-like Enhancement” is a magnetic resonance imaging abnormality specific to neuromyelitis optica. Ann Neurol. 2009;66:425–8.

    Article  PubMed  Google Scholar 

  16. Kim SH, Kim W, Li XF, Jung IJ, Kim HJ. Does interferon beta treatment exacerbate neuromyelitis optica spectrum disorder? Mult Scler. 2012;18:1480–3.

    Article  PubMed  Google Scholar 

  17. McKeon A, Lennon VA, Lotze T, et al. CNS aquaporin-4 autoimmunity in children. Neurology. 2008;71:93–100.

  18. Magana SM, Matiello M, Pittock SJ, et al. Posterior reversible encephalopathy syndrome in neuromyelitis optica spectrum disorders. Neurology. 2009;72:712–7.

    Article  CAS  PubMed  Google Scholar 

  19. Hwang J, Kim BJ, Lee KH. A case of neuromyelitis optica combined with Sjogren’s syndrome presenting posterior reversible encephalopathy syndrome. J Mult Scler. 2010;1:27–9.

    Google Scholar 

  20. Torisu H, Kira R, Ishizaki Y, et al. Clinical study of childhood acute disseminated encephalomyelitis, multiple sclerosis, and acute transverse myelitis in Fukuoka prefecture Japan. Brain Dev. 2010;32:454–62.

    Article  PubMed  Google Scholar 

  21. Pavone P, Pettoello-Mantovano M, Le Pira A, et al. Acute disseminated encephalomyelitis: a long- term prospective study and meta-analysis. Neuro-pediatrics. 2010;41:246–55.

    CAS  Google Scholar 

  22. Marin SE, Callen DJ. The magnetic resonance imaging appearance of monophasic acute disseminated encephalomyelitis: an update post application of the 2007 consensus criteria. Neuroimaging Clin N Am. 2013;23:245–66.

    Article  PubMed  Google Scholar 

  23. Chong HT, Li PCK, Ong B, et al. Pediatric multiple sclerosis is similar to adult-onset form in Asia. Neurology Asia. 2007;12:37–40.

    Google Scholar 

  24. Sahraian MA, Radue EW, Minagar A. Neuromyelitis optica: clinical manifestations and neuroimaging features. Neurol Clin. 2013;31:139–52.

    Article  PubMed  Google Scholar 

  25. Chabas D, Green AJ, Waubant E. Pediatric multiple sclerosis. Neuro RX. 2006;3:264–75.

    Article  CAS  Google Scholar 

  26. Renoux C, Vukusic S, Mikaeloff Y, Edan G, Clanet M, Dubois B. Natural history of multiple sclerosis with childhood onset. N Engl J Med. 2007;356:2603–13.

    Article  CAS  PubMed  Google Scholar 

  27. Pena JA, Lotze TE. Pediatric multiple sclerosis: current concepts and consensus definitions. Autoimm Dis. 2013;2013:Article ID 673947. 10.1155/2013/673947

  28. Dale RC, Brilot F, Banwell B. Pediatric central nervous system inflammatory demyelination: acute disseminated encephalomyelitis, clinically isolated syndromes, neuromyelitis optica, and multiple sclerosis. Curr Opin Neurol. 2009;22:233–40.

    Article  PubMed  Google Scholar 

  29. Simon JH, Kleinschmidt-DeMasters BK. Variants of multiple sclerosis. Neuroimaging Clin N Am. 2008;18:703–16.

    Article  PubMed  Google Scholar 

  30. Murthy JM. Acute disseminated encephalomyelitis. Neurol India. 2002;50:238–43.

    CAS  PubMed  Google Scholar 

  31. Waldman A, Ghezzi A, Bar-Or A, Mikaeloff Y, Tardieu M, Banwell B. Multiple sclerosis in children: an update on clinical diagnosis, therapeutic strategies, and research. Lancet Neurol. 2014;13:936–48.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Verhey LH, Shroff M, Banwell B. Pediatric multiple sclerosis pathobiological, clinical, and magnetic resonance imaging features. Neuroimaging Clin N Am. 2013;23:227–43.

    Article  PubMed  Google Scholar 

  33. Sherman E, Han MH. Acute and chronic management of neuromyelitis optica spectrum disorder. Curr Treat Options Neurol. 2015;17:48.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Weinshenker BG, Wingerchuk DM. The two faces of neuromyelitis optica. Neurology. 2014;82:466–7.

    Article  PubMed  Google Scholar 

  35. Moharir M, Shroff M, Benseler SM. Childhood central nervous system vasculitis. Neuroimaging Clin N Am. 2013;23:293–308.

    Article  PubMed  Google Scholar 

  36. Calabrese LH, Mallek JA. Primary angiitis of the central nervous system. Report of 8 new cases, review of the literature, and proposal for diagnostic criteria. Medicine (Baltimore). 1988;67:20–39.

    Article  CAS  Google Scholar 

  37. Hajj-Ali RA, Singhal AB, Benseler S, Molloy E, Calabrese LH. Primary angiitis of the CNS. Lancet Neurol. 2011;10:561–72.

    Article  PubMed  Google Scholar 

  38. Benseler SM, DeVeber G, Hawkins C, et al. Angiography-negative primary central nervous system vasculitis in children: a newly recognized inflammatory central nervous system disease. Arthritis Rheum. 2005;52:2159–67.

    Article  PubMed  Google Scholar 

  39. Benseler SM, Silverman E, Aviv RI, et al. Primary central nervous system vasculitis in children. Arthritis Rheum. 2006;54:1291–7.

    Article  PubMed  Google Scholar 

  40. McGlennan C, Ganesan V. Delays in investigation and management of acute arterial ischaemic stroke in children. Dev Med Child Neurol. 2008;50:537–40.

    Article  PubMed  Google Scholar 

  41. Srinivasan J, Miller SP, Phan TG, Mackay MT. Delayed recognition of initial stroke in children: need for increased awareness. Pediatrics. 2009;124:227–34.

  42. Husson B, Rodesch G, Lasjaunias P, Tardieu M, Sébire G. Magnetic resonance angiography in childhood arterial brain infarcts-a comparative study with contrast angiography. Stroke. 2002;33:1280–5.

    Article  PubMed  Google Scholar 

  43. Belizna CC, Hamidou MA, Levesque H, Guillevin L, Shoenfeld Y. Infection and vasculitis. Rheumatology. 2009;48:475–82.

    Article  PubMed  Google Scholar 

  44. Fullerton HJ1, Elkind MS, Barkovich AJ, et al. The vascular effects of infection in Pediatric Stroke (VIPS) Study. J Child Neurol. 2011;26:1101–10.

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Contributions

SVS: Draft of manuscript, collection of data and references; KM: Collection of data, preparation of clinical vignettes tables; SM: Refinement of draft; SG: Refinement of draft and will act as guarantor of the paper; MS: Approval of draft, contribution of cases and suggestions.

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Correspondence to Sniya Valsa Sudhakar.

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Sudhakar, S.V., Muthusamy, K., Mani, S. et al. Imaging in Pediatric Demyelinating and Inflammatory Diseases of Brain- Part 2. Indian J Pediatr 83, 965–982 (2016). https://doi.org/10.1007/s12098-016-2052-z

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  • DOI: https://doi.org/10.1007/s12098-016-2052-z

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