Clinical features of myelin oligodendrocyte glycoprotein antibody-related diseases associated with seizures
- VernacularTitle:伴癫痫发作的髓鞘少突胶质细胞糖蛋白抗体相关疾病的临床特点
- Author:
Jingjing QIN
1
;
Jianping WANG
1
;
Chenguang ZHOU
1
Author Information
- Publication Type:Journal Article
- Keywords: Myelin oligodendrocyte glycoprotein; Seizures; Isolated seizures
- From: Journal of Apoplexy and Nervous Diseases 2022;39(7):601-604
- CountryChina
- Language:Chinese
- Abstract: Abstract To describe the clinical features of myelin oligodendrocyte glycoprotein antibody-related diseases associated with seizures. MethodsPatients with positive blood or cerebrospinal fluid MOG antibody test who were admitted to the Fifth Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital of Zhengzhou University from April 2016 to April 2021 were retrospectively analyzed to understand the general data，clinical features，laboratory examination，imaging examination，EEG results，treatment and prognosis of patients with seizures in the course of the disease. ResultsFifteen patients（21.4%，15/70）with positive MOG antibody had seizures at the first onset，including 11 children and 4 adults，with an average onset age of 17.4 years（3-53 years）. The clinical manifestations were ADEM-like in 6 cases，unilateral cortical encephalitis in 5 cases，isolated seizures in 3 cases and anti-NMDAR encephalitis in 1 case. The types of epileptic seizures are generalized tonic-clonic seizures in 10 cases，focal motor seizures in 3 cases and status epilepticus in 2 cases. In addition to headache，fever and corresponding cortical related symptoms，it can also involve the brain stem，optic nerve and spinal cord. In the acute phase，EEG is often abnormal，and slow-wave changes appear in the cortex area corresponding to the involved side.Head MRI often shows cortical involvement，showing local cortical swelling，shallow sulcus，the high signal in FLAIR，and enhanced meningeal linear enhancement. Glucocorticoid or combined with human immunoglobulin is effective in the acute phase. After 2-31 months follow up，6 patients relapsed，5 patients were treated with immunosuppressant，and 10 patients were prolonged with antiepileptic drugs. ConclusionsSeizures is common in MOG antibody related diseases，mostly in the clinical phenotype of ADEM and unilateral cortical encephalitis. The most common seizure type is a generalized tonic-clonic seizure，and the cortex on the affected side of EEG shows slow wave changes. Head MRI usually involves cerebral cortex and subcortical white matter，and some patients with isolated epilepsy may have typical demyelinating changes afterwards. Immunotherapy is effective in the acute stage，and some patients need to be treated with immunosuppressants and extended antiepileptic drugs.
- Full text:2024072323254797951Clinical features of myelin oligodendrocyte glycoprotein antibodyrelated diseases associated with seizures.pdf
