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Seizures in Chinese Patients with Myelin Oligodendrocyte Glycoprotein Encephalomyelitis: A retrospective study in single center

Zhong, X.N., Zhou, Y.F., Chang, Y.Y., Wang, J.Q., Shu, Y.Q., Sun, X.B., Peng, L.S., Lau, A.Y., Kermode, A.G. and Qiu, W. (2019) Seizures in Chinese Patients with Myelin Oligodendrocyte Glycoprotein Encephalomyelitis: A retrospective study in single center. Multiple Sclerosis Journal, 25 (3). p. 481.

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Background: Myelin oligodendrocyte glycoprotein (MOG) antibody associated encephalomyelitis is increasingly being considered a distinct disease entity, with seizure and encephalopathy commonly reported.

Object: To investigate the clinical features of MOG-IgG positive patients with seizures and /or encephalopathy in a single cohort.

Methods: Overall, 58 patients seropositive for MOG-IgG, including 23 paitents with seizures and/or encephalopathy and 35 patients without seizures or encephalopathy were included.

Results: The incidence of seizures and/or encephalopathy was 39.66% (23/58). Either at disease onset or throughout the course of disease, meningeal irritation (P=0.030, P=0.011), fever (P=0.001, P=0.000), headache (P=0.001, P=0.000), nausea and vomiting (P=0.004, P=0.000) were significantly higher in patients with seizures and/or encephalopathy than the control group. There was less optic nerve (P=0.003) and spinal cord (P=0.037) involvement in the patients with seizures and/or encephalopathy. CSF leukocytes were elevated in both seizures and/or encephalopathy group and the control group. Most of MOG encephalomyelitis patients had cortical/subcortical lesions, including 65.2%(15/23) in the seizures and/or encephalopathy group and 50.0%(13/26) in the control group. Subgroup analysis showed that 30%(7/23) MOG-IgG positive subjects with seizures and/or encephalopathy had been misdiagnosed for central nervous system infection due to meningoencephalitis symptom and elevated CSF leukocytes (P=0.002).

Conclusions: Seizures and encephalopathy are not rare in MOG encephalomyelitis, which may be associated with cortical/subcortical brain lesion. MOG encephalomyelitis patients often combined meningoencephalitis symptom and abnormal CSF presentation, mimic CNS infection.

Item Type: Journal Article
Murdoch Affiliation(s): Institute for Immunology and Infectious Diseases
Publisher: Sage Publications
Other Information: Poster presentation - PACTRIMS 2018
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