Clinical spectrum of aquired demyelinating disorders presenting in Children Hospital Multan; A tertiary care Hospital
Keywords:
Children, Demyelinating Disease, Encephalomyelitis, Myelin Oligodendrocyte GlycoproteinAbstract
Objective: This study was planned to describe the experience of clinical spectrum, neuroimaging characteristics, and short-term outcomes of acquired demyelinating disorders (ADD).
Study design: Prospective, cohort study.
Setting: The Neurology Department of The Children’s Hospital and Institute of Child Health, Multan, Pakistan.
Period: April 2024 to June 2025.
Material and methods: Using non-probability consecutive sampling, children aged 1 month to 18 years presenting with a first episode of acquired CNS demyelination were analyzed. Baseline demographic, clinical, laboratory, and imaging data were recorded. Participants were reassessed at 3 months for outcomes. Data were analyzed using IBM-SPSS Statistics, version 26, with p<0.05 considered significant.
Results: In a total of 52 children, 29 (55.8%) were males, and 23 (44.2%) females, with a median age of 9.0 (IQR 6.0–9.0) years. The median duration from symptom onset to presentation was 6.0 (IQR 3.0–11.0) days, and a preceding febrile illness was reported in 18 (34.6%) children. Baseline syndromes included optic neuritis in 17 (32.7%), acute disseminated encephalomyelitis in 13 (25.0%), transverse myelitis in 11 (21.2%), and clinically isolated syndrome in 11 (21.2%). myelin oligodendrocyte glycoprotein (MOG) antibody associated disease was identified in 14 (26.9%) children. Acute immunotherapy was administered to 44 (84.6%) children. At 3 months, 42 children completed the follow up evaluation, and out of these, complete recovery was reported in 26 (61.9%), partial recovery in 12 (28.6%), relapse or deterioration in 3 (7.1%), and death in 1 (2.4%).
Conclusion: Children presenting with acquired demyelinating disorders showed a diagnostic spectrum in which MOG antibody associated disease and ADEM related phenotypes formed a substantial component, with pediatric onset multiple sclerosis and NMOSD contributing smaller but clinically important fractions.
