<> "The repository administrator has not yet configured an RDF license."^^ . <> . . . "MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 3: Brainstem involvement - frequency, presentation and outcome"^^ . "Background: Myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) are present in a subset of aquaporin-4 (AQP4)-IgG-negative patients with optic neuritis (ON) and/or myelitis. Little is known so far about brainstem involvement in MOG-IgG-positive patients. Objective: To investigate the frequency, clinical and paraclinical features, course, outcome, and prognostic implications of brainstem involvement in MOG-IgG-positive ON and/or myelitis. Methods: Retrospective case study. Results: Among 50 patients with MOG-IgG-positive ON and/or myelitis, 15 (30%) with a history of brainstem encephalitis were identified. All were negative for AQP4-IgG. Symptoms included respiratory insufficiency, intractable nausea and vomiting (INV), dysarthria, dysphagia, impaired cough reflex, oculomotor nerve palsy and diplopia, nystagmus, internuclear ophthalmoplegia (INO), facial nerve paresis, trigeminal hypesthesia/dysesthesia, vertigo, hearing loss, balance difficulties, and gait and limb ataxia; brainstem involvement was asymptomatic in three cases. Brainstem inflammation was already present at or very shortly after disease onset in 7/15 (47%) patients. 16/21 (76.2%) brainstem attacks were accompanied by acute myelitis and/or ON. Lesions were located in the pons (11/13), medulla oblongata (8/14), mesencephalon (cerebral peduncles; 2/14), and cerebellar peduncles (5/14), were adjacent to the fourth ventricle in 2/12, and periaqueductal in 1/12; some had concomitant diencephalic (2/13) or cerebellar lesions (1/14). MRI or laboratory signs of blood-brain barrier damage were present in 5/12. Cerebrospinal fluid pleocytosis was found in 11/14 cases, with neutrophils in 7/11 (3-34% of all CSF white blood cells), and oligoclonal bands in 4/14. Attacks were preceded by acute infection or vaccination in 5/15 (33.3%). A history of teratoma was noted in one case. The disease followed a relapsing course in 13/15 (87%); the brainstem was involved more than once in 6. Immunosuppression was not always effective in preventing relapses. Interferon-beta was followed by new attacks in two patients. While one patient died from central hypoventilation, partial or complete recovery was achieved in the remainder following treatment with high-dose steroids and/or plasma exchange. Brainstem involvement was associated with a more aggressive general disease course (higher relapse rate, more myelitis attacks, more frequently supratentorial brain lesions, worse EDSS at last follow-up). Conclusions: Brainstem involvement is present in around one third of MOG-IgG-positive patients with ON and/or myelitis. Clinical manifestations are diverse and may include symptoms typically seen in AQP4-IgG-positive neuromyelitis optica, such as INV and respiratory insufficiency, or in multiple sclerosis, such as INO. As MOG-IgG-positive brainstem encephalitis may take a serious or even fatal course, particular attention should be paid to signs or symptoms of additional brainstem involvement in patients presenting with MOG-IgG-positive ON and/or myelitis."^^ . "2016" . . "13" . "281" . . "BioMed Central"^^ . . . "Journal of Neuroinflammation"^^ . . . "17422094" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "Orhan"^^ . "Aktas"^^ . "Orhan Aktas"^^ . . "Marius"^^ . "Ringelstein"^^ . "Marius Ringelstein"^^ . . "Oliver"^^ . "Stich"^^ . "Oliver Stich"^^ . . "Mathias"^^ . "Buttmann"^^ . "Mathias Buttmann"^^ . . "Kalliopi"^^ . "Pitarokoili"^^ . "Kalliopi Pitarokoili"^^ . . "Klemens"^^ . "Ruprecht"^^ . "Klemens Ruprecht"^^ . . "Brigitte"^^ . "Wildemann"^^ . "Brigitte Wildemann"^^ . . "Kathrin"^^ . "Schanda"^^ . "Kathrin Schanda"^^ . . "Friedemann"^^ . "Paul"^^ . "Friedemann Paul"^^ . . "Alexander U."^^ . "Brandt"^^ . "Alexander U. Brandt"^^ . . "Nasrin"^^ . "Asgari"^^ . "Nasrin Asgari"^^ . . "Kai"^^ . "Fechner"^^ . "Kai Fechner"^^ . . "Corinna"^^ . "Trebst"^^ . "Corinna Trebst"^^ . . "Diego"^^ . "Franciotta"^^ . "Diego Franciotta"^^ . . "Nadja"^^ . "Borisow"^^ . "Nadja Borisow"^^ . . "Mirjam"^^ . "Korporal-Kuhnke"^^ . "Mirjam Korporal-Kuhnke"^^ . . "Judith"^^ . "Strobl"^^ . "Judith Strobl"^^ . . "Lena-Alexandra"^^ . "Beume"^^ . "Lena-Alexandra Beume"^^ . . "Alexander"^^ . "Schwarz"^^ . "Alexander Schwarz"^^ . . "Sven"^^ . "Jarius"^^ . "Sven Jarius"^^ . . "Jürgen"^^ . "Haas"^^ . "Jürgen Haas"^^ . . "Ingo"^^ . "Kleiter"^^ . "Ingo Kleiter"^^ . . "Markus"^^ . "Reindl"^^ . "Markus Reindl"^^ . . "Hanna"^^ . "Zimmermann"^^ . "Hanna Zimmermann"^^ . . "Martin W."^^ . "Hümmert"^^ . "Martin W. Hümmert"^^ . . "Carsten"^^ . "Lukas"^^ . "Carsten Lukas"^^ . . "Florence"^^ . "Pache"^^ . "Florence Pache"^^ . . "Alexander"^^ . "Winkelmann"^^ . "Alexander Winkelmann"^^ . . . . . . "MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 3: Brainstem involvement - frequency, presentation and outcome (PDF)"^^ . . . "12974_2016_Article_719.pdf"^^ . . . "MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 3: Brainstem involvement - frequency, presentation and outcome (Other)"^^ . . . . . . "lightbox.jpg"^^ . . . "MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 3: Brainstem involvement - frequency, presentation and outcome (Other)"^^ . . . . . . "preview.jpg"^^ . . . "MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. 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