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de Mol CL, Wong YYM, van Pelt ED, Ketelslegers IA, Bakker DP, Boon M, Braun KPJ, van Dijk KGJ, Eikelenboom MJ, Engelen M, Geleijns K, Haaxma CA, Niermeijer JMF, Niks EH, Peeters EAJ, Peeters-Scholte CMPCD, Poll-The BT, Portier RP, de Rijk-van Andel JF, Samijn JPA, Schippers HM, Snoeck IN, Stroink H, Vermeulen RJ, Verrips A, Visscher F, Vles JSH, Willemsen MAAP, Catsman-Berrevoets CE, Hintzen RQ, Neuteboom RF. Incidence and outcome of acquired demyelinating syndromes in Dutch children: update of a nationwide and prospective study. J Neurol 2018; 265:1310-1319. [PMID: 29569176 PMCID: PMC5990581 DOI: 10.1007/s00415-018-8835-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Acquired demyelinating syndromes (ADS) are immune-mediated demyelinating disorders of the central nervous system in children. A nationwide, multicentre and prospective cohort study was initiated in the Netherlands in 2006, with a reported ADS incidence of 0.66/100,000 per year and MS incidence of 0.15/100,000 per year in the period between 2007 and 2010. In this study, we provide an update on the incidence and the long-term follow-up of ADS in the Netherlands. METHODS Children < 18 years with a first attack of demyelination were included consecutively from January 2006 to December 2016. Diagnoses were based on the International Paediatric MS study group consensus criteria. Outcome data were collected by neurological and neuropsychological assessments, and telephone call assessments. RESULTS Between 2011 and 2016, 55/165 of the ADS patients were diagnosed with MS (33%). This resulted in an increased ADS and MS incidence of 0.80/100,000 per year and 0.26/100,000 per year, respectively. Since 2006 a total of 243 ADS patients have been included. During follow-up (median 55 months, IQR 28-84), 137 patients were diagnosed with monophasic disease (56%), 89 with MS (37%) and 17 with multiphasic disease other than MS (7%). At least one form of residual deficit including cognitive impairment was observed in 69% of all ADS patients, even in monophasic ADS. An Expanded Disability Status Scale score of ≥ 5.5 was reached in 3/89 MS patients (3%). CONCLUSION The reported incidence of ADS in Dutch children has increased since 2010. Residual deficits are common in this group, even in monophasic patients. Therefore, long-term follow-up in ADS patients is warranted.
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Affiliation(s)
- C L de Mol
- Department of Neurology, MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands
| | - Y Y M Wong
- Department of Neurology, MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands
| | - E D van Pelt
- Department of Neurology, MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands
| | - I A Ketelslegers
- Department of Neurology, MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands
| | - D P Bakker
- Department of Paediatric Neurology, VU Medical Centre, Amsterdam, The Netherlands
| | - M Boon
- Department of Paediatric Neurology, UMCG, Groningen, The Netherlands
| | - K P J Braun
- Department of Paediatric Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - K G J van Dijk
- Department of Paediatrics, Rijnstate Hospital, Arnhem, The Netherlands
| | - M J Eikelenboom
- Department of Neurology, Westfriesgasthuis, Hoorn, The Netherlands
| | - M Engelen
- Department of Paediatric Neurology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - K Geleijns
- Department of Paediatric Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - C A Haaxma
- Department of Paediatric Neurology, Radboud UMC, Nijmegen, The Netherlands
| | - J M F Niermeijer
- Department of Neurology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - E H Niks
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - E A J Peeters
- Department of Paediatric Neurology, Juliana Children Hospital/Haga Hospital, The Hague, The Netherlands
| | | | - B T Poll-The
- Department of Paediatric Neurology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - R P Portier
- Department of Neurology, Medical Spectrum Twente, Enschede, The Netherlands
| | | | - J P A Samijn
- Department of Neurology, Maasstad Hospital, Rotterdam, The Netherlands
| | - H M Schippers
- Department of Neurology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - I N Snoeck
- Department of Paediatric Neurology, Juliana Children Hospital/Haga Hospital, The Hague, The Netherlands
| | - H Stroink
- Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - R J Vermeulen
- Department of Neurology, Maastricht UMC, Maastricht, The Netherlands
| | - A Verrips
- Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - F Visscher
- Department of Paediatric Neurology, Admiraal de Ruyter Hospital, Goes, The Netherlands
| | - J S H Vles
- Department of Neurology, Maastricht UMC, Maastricht, The Netherlands
| | - M A A P Willemsen
- Department of Paediatric Neurology, Radboud UMC, Nijmegen, The Netherlands
| | - C E Catsman-Berrevoets
- Paediatric Neurology, Erasmus MC-Sophia, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - R Q Hintzen
- Department of Neurology, MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands
| | - R F Neuteboom
- Paediatric Neurology, Erasmus MC-Sophia, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
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Coebergh JA, Fransen van de Putte DE, Snoeck IN, Ruivenkamp C, van Haeringen A, Smit LM. A new variable phenotype in spinocerebellar ataxia 27 (SCA 27) caused by a deletion in the FGF14 gene. Eur J Paediatr Neurol 2014; 18:413-5. [PMID: 24252256 DOI: 10.1016/j.ejpn.2013.10.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 10/06/2013] [Accepted: 10/20/2013] [Indexed: 10/26/2022]
Abstract
We present a young boy whose mild ataxia and abnormal eye movements repeatedly deteriorated with fever, making him unable to sit or walk during fever episodes. SNP-array analysis identified a 202 kb deletion in chromosome 13q33.1 containing the fibroblast growth factor (FGF)14 gene, which is associated with spinocerebellar ataxia (SCA) 27. This 13q deletion was also present in the proband's mother and grandmother. The mother was unable to perform tandem gait walking and had abnormal eye movements but had never sought medical attention. The grandmother predominantly had a postural tremor. FGF14 regulates brain sodium channels, especially in the cerebellum. Sodium channels can be fever sensitive. This family demonstrates phenotypic variability of FGF14 deletions (SCA 27), fever sensitivity of ataxia and the added value of SNP-array analysis in making a diagnosis.
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Affiliation(s)
- J A Coebergh
- Department of Paediatric Neurology, Haga Teaching Hospital, The Hague, The Netherlands; Department of Neurology, Ashford and St Peter's Hospitals, United Kingdom; Department of Neurology, St George's Hospitals, United Kingdom.
| | | | - I N Snoeck
- Department of Paediatric Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - C Ruivenkamp
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - A van Haeringen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - L M Smit
- Department of Paediatric Neurology, Haga Teaching Hospital, The Hague, The Netherlands
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Ketelslegers IA, Catsman-Berrevoets CE, Neuteboom RF, Boon M, van Dijk KGJ, Eikelenboom MJ, Gooskens RHJM, Niks EH, Overweg-Plandsoen WCG, Peeters EAJ, Peeters-Scholte CMPCD, Poll-The BT, de Rijk-van Andel JF, Samijn JPA, Snoeck IN, Stroink H, Vermeulen RJ, Verrips A, Vles JSH, Willemsen MAAP, Rodrigues Pereira R, Hintzen RQ. Incidence of acquired demyelinating syndromes of the CNS in Dutch children: a nationwide study. J Neurol 2012; 259:1929-35. [PMID: 22349866 PMCID: PMC3432787 DOI: 10.1007/s00415-012-6441-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 01/23/2012] [Accepted: 01/25/2012] [Indexed: 12/01/2022]
Abstract
Acquired demyelinating syndromes (ADS) can be a first presentation of multiple sclerosis (MS) in children. The incidence of these disorders in Europe is currently unknown. Children (<18 years old) living in the Netherlands who presented with ADS were included from January 1, 2007 to December 31, 2010 by the Dutch pediatric MS study group and the Dutch surveillance of rare pediatric disorders. Demographic and clinical data were collected. Eighty-six patients were identified over 4 years, resulting in an incidence of 0.66/1,00,000 per year. Most patients presented with polyfocal ADS without encephalopathy (30%), followed by polyfocal ADS with encephalopathy (24%), optic neuritis (ON, 22%), monofocal ADS (16%), transverse myelitis (3%), and neuromyelitis optica (3%). Patients with polyfocal ADS with encephalopathy were younger (median 3.9 years) than patients with ON (median 14.6 years, p < 0.001) or monofocal ADS (median 16.0 years, p < 0.001). Patients with polyfocal ADS without encephalopathy (median 9.2 years) were also younger than monofocal ADS patients (median 16.0 years, p < 0.001). There was a slight female preponderance in all groups except the ON group, and a relatively large number of ADS patients (29%) reported a non-European ancestry. Familial autoimmune diseases were reported in 23%, more often in patients with relapsing disease than monophasic disease (46 vs. 15%, p = 0.002) and occurring most often in the maternal family (84%, p < 0.001). During the study period, 23% of patients were subsequently diagnosed with MS. The annual incidence of ADS in the Netherlands is 0.66/1,00,000 children/year. A polyfocal disease onset of ADS was most common.
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Affiliation(s)
- I A Ketelslegers
- MS Centre ErasMS, Department of Neurology, Room Ee 2230, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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