Diagnosis and prognosis of acute inflammatory disorders of the central nervous system in both children and adults would be aided by the availability of serum
biomarkers.
Antibodies directed against the aquaporin-4
water channel has led to recognition of
neuromyelitis optica (NMO) and
NMO spectrum disorders in both children and adults and to the ability to predict a relapsing disease course in antibody-positive patients. Serum
antibodies directed against myelin
antigens are detectable in approximately one third of children with
acute disseminated encephalomyelitis (ADEM) at the time of acute illness, and in approximately 25% of children with
multiple sclerosis (MS) in whom seropositivity persists. Whether circulating
antibodies contribute to disease pathogenesis or are secondary to cell damage is an area of active study. The contribution of T-cells, eosinophils, neutrophils,
infection and blood brain barrier permeability are also receiving increasing attention in antibody-associated inflammatory
demyelination. The present manuscript reviews the current clinical, laboratory and immunological features of acquired CNS
inflammation in children.