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Reviews advances including regulatory-approved pediatric MS treatments and the clinical impact of MOG and AQP4 antibodies for defining distinct syndromes.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/pediatric-central-nervous-system-demyelinating-diseases/526651/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/pediatric-central-nervous-system-demyelinating-diseases/526651.png","ImageObject",300,407,{"name":42,"@type":43},"LangkahRina","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-10","2026-10-08",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What 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2026](https://continuum.aan.com by 77.232.58.146 on 8 October 2026)  \nPediatric Central Nervous System Demyelinating Diseases  \nBy Tanuja Chitnis, MD, FAAN  \nABSTRACT  \nPURPOSE OF REVIEW: This article provides an up-to-date summary of the categories, diagnosis, and management of pediatric demyelinating disorders.  \nRECENT FINDINGS: Understanding of the diverse spectrum of pediatric demyelinating disorders, including monophasic and multiphasic forms, has improved. Pediatric multiple sclerosis (MS) is the most common demyelinating disorder in children, and recent genetic and environmental risk research has clarified that pediatric MS is on the same continuum of disease as adult MS. Recent advances in the treatment of pediatric MS include clinical trials leading to regulatory agency–approved treatments. The identification of myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies in children has been a major advance, allowing for appropriate treatment and management of these syndromes.  \nSUMMARY: Antibody testing is now helping to define subtypes of pediatric demyelinating disorders, including myelin oligodendrocyte glycoprotein–seropositive and aquaporin-4–seropositive cases that are distinct from pediatric MS. Treatments for pediatric MS are being evaluated in clinical trials.  \nINTRODUCTION  \nS  \nignificant progress has been made in the field of pediatric central nervous system (CNS) demyelinating disorders over the past 5 years. These disorders include acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and clinically isolated syndromes. Major  \nadvances in the past 5 years include improved diagnostic criteria, antibody-based biomarkers, predictors ofa multiphasic course, and treatment advances for these disorders, which are summarized in this article. Recent work on the genetic and environmental risk factors for pediatric MS points to similarities with adult disease. Immunobiological studies for MS suggest a continuum of disease with adult disease; however, both clinical and immunobiological features point to amore inflammatory profile in children.1,2 Characterizations of the pediatric phenotypes associated with aquaporin-4 (AQP4) antibody–seropositive NMO and myelin oligodendrocyte glycoprotein (MOG) antibody–associated disease  \nREVIEW ARTICLE  \n􀀁  \nCONTINUUM AUDIO INTERVIEW AVAILABLE ONLINE  \nCITE AS:  \nCONTINUUM (MIN NEA P M INN) 2019;25(3, MULTIPLE SCLEROSIS AND OTHER CNS INFLAMMATORY DISEASES):793–814.  \nAddress correspondence to Dr Tanuja Chitnis, 55 Fruit St, ACC708, Massachusetts General Hospital, Boston, MA 02114, tchitnis@rics.bwh.  \n[harvard.edu](harvard.edu).  \nRELATIONSHIP DISCLOSURE: Dr Chitnis serves on scientific advisory boards for Biogen, Celgene Corporation,  \nF. Hoffmann-La Roche Ltd, Novartis AG, and Sanofi Genzyme and as a consultant for Biogen. Dr Chitnis receives research/grant support from the Consortium of Multiple Sclerosis Centers; the Department of Defense; EMD Serono, Inc; the Guthy-Jackson Charitable Foundation;  \nMallinckrodt Pharmaceuticals; the National Institutes of Health (R01AG057505); the National Multiple Sclerosis Society; Novartis AG; Octave Bioscience; and Verily Life Sciences LLC.  \nUNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE:  \nDr Chitnis discusses the unlabeled/investigational use of glatiramer acetate, interferon beta, natalizumab, and rituximab for pediatric multiple sclerosis and mycophenolate mofetil for myelin oligodendrocyte glycoprotein antibody– associated disorders and neuromyelitis optica spectrum disorder in children.  \n© 2019 American Academy of Neurology.  \nCONTINUUM JOURNAL . COM 793  \nCopyright © American Academy of Neurology. Unauthorized reproduction of this article is prohibited.  \nPEDIATRIC CNS DEMYELINATING DISEASES  \nDownloaded from [https://continuum.aan.com by 77.232.58.146 on 8 October 2026](https://","cbCaivlVdAgZ838y","https://ap.wps.com/l/cbCaivlVdAgZ838y","pdf",425843,22,"English","# Abstract\n# Purpose of Review\n# Recent Findings\n# Summary\n# Introduction\n# Classification of Pediatric CNS Demyelinating Diseases\n## Monophasic vs Multiphasic Disorders\n## Acute Demyelinating Syndromes and Clinically Isolated Syndromes\n## Role of ADEM in First Attacks","[{\"question\":\"What are the main categories of pediatric CNS demyelinating diseases?\",\"answer\":\"They are generally classified as monophasic or multiphasic disorders, and a seemingly monophasic episode may represent the first attack of a multiphasic disorder.\"},{\"question\":\"How is pediatric multiple sclerosis positioned relative to adult disease?\",\"answer\":\"Pediatric multiple sclerosis is described as on the same continuum of disease as adult multiple sclerosis, supported by genetic and environmental risk research and immunobiological studies.\"},{\"question\":\"Why are MOG and AQP4 antibodies important in pediatric syndromes?\",\"answer\":\"Their identification in children is described as a major advance, helping define subtypes such as MOG-seropositive and AQP4-seropositive cases that are distinct from pediatric multiple sclerosis.\"}]","Pediatric Central Nervous System Demyelinating Diseases | PDF",1791499688,55]