Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · May 2013
ReviewMimics and rare presentations of pediatric demyelination.
This article reviews the features that should prompt consideration of diseases that mimic acquired demyelinating syndromes and multiple sclerosis using vignettes to highlight unusual clinical and radiologic features. Cases of transverse myelitis, spinal infarction, acute disseminated encephalomyelitis, fever-induced refractory epileptic encephalopathy in school-aged children, small-vessel vasculitis, Griscelli syndrome type 2, cysticercosis, vitamin B12 deficiency, and chronic relapsing inflammatory optic neuropathy are presented.
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Neuroimaging Clin. N. Am. · May 2013
ReviewStandardized magnetic resonance imaging acquisition and reporting in pediatric multiple sclerosis.
Magnetic resonance (MR) imaging is one of the most important paraclinical tools for the diagnosis of multiple sclerosis (MS), and monitoring of disease progression and treatment response. This article provides clinicians and neuroradiologists caring for children with demyelinating disorders with a suggested standard MR imaging acquisition and reporting protocol, and defines a standard lexicon for lesion features typical of MS in children. As there is considerable overlap between the MR imaging features of pediatric- and adult-onset MS, the recommendations provided herein may be of relevance to radiologists and clinicians caring for adults with multiple sclerosis.
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Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disorder typically characterized by attacks of recurrent optic neuritis and transverse myelitis. Advances in magnetic resonance imaging techniques and the discovery of the relatively specific NMO IgG biomarker have led to improved diagnostic accuracy and greater recognition of the broad clinical spectrum of aquaporin 4-related autoimmunity. Brain lesions in NMO typically follow the distribution of aquaporin 4 expression and may be symptomatic. Prompt diagnosis of NMO and NMO spectrum disorders has important therapeutic implications given the high risk of recurrent attacks and consequent severe disability, especially in childhood-onset disease.
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Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a severe but potentially reversible neurologic disorder that is clinically recognizable in children and adolescents. Prompt diagnosis and treatment are essential to facilitate recovery. ⋯ Patients with tumor-associated encephalitis benefit from tumor resection. More than 75% of patients make a substantial recovery, which occurs in the reverse order of symptom presentation associated with a decline in antibody titers.