儿童MOGAD痫性发作的诊疗发展
Advances in Diagnosis and Treatment of Seizures in Pediatric MOGAD
DOI: 10.12677/acm.2026.1651863, PDF,   
作者: 彭怡洁, 李秀娟*：重庆市重庆医科大学附属儿童医院神经内科，儿童少年健康与疾病国家临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿童神经发育与认知障碍重庆市重点实验室，重庆
关键词: 髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)；痫性发作；临床特点；治疗；儿童；Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)； Seizures； Clinical Features； Treatment； Children
摘要: 髓鞘少突胶质细胞糖蛋白抗体相关疾病(myelin oligodendrocyte glycoprotein antibody associated disease, MOGAD)是由MOG抗体介导的中枢神经系统炎性脱髓鞘疾病，在儿童中具有独特的临床特征。痫性发作是儿童MOGAD常见的临床表现之一，发生率高达20%~40%，远高于其他炎性脱髓鞘疾病。既往有关MOGAD痫性发作研究多集中成人群体，儿童群体研究较为有限。故本文旨在系统综述儿童群体MOGAD痫性发作的诊疗发展，并且从病理机制、临床特征及治疗策略这几个方面开展详细描述，为临床早期诊断和精确诊疗提供科学参考依据。
Abstract: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory demyelinating disease of the central nervous system mediated by MOG antibodies, with a relatively high incidence among children. Seizures are one of the common clinical manifestations of MOGAD in children, with an incidence as high as 20%~40%, which is significantly higher than that of other inflammatory demyelinating diseases. Previous studies on MOGAD seizures have primarily focused on adult populations, while research on pediatric populations remains limited. Therefore, this article aims to provide a systematic review of the diagnostic and therapeutic developments regarding MOGAD-associated seizures in children. It offers a detailed description of the pathological mechanisms, clinical features, and treatment strategies to provide a scientific basis for early clinical diagnosis and precise management.
文章引用：彭怡洁, 李秀娟. 儿童MOGAD痫性发作的诊疗发展[J]. 临床医学进展, 2026, 16(5): 695-701. https://doi.org/10.12677/acm.2026.1651863

参考文献

[1] 中华医学会神经病学分会神经免疫学组. 中国髓鞘少突胶质细胞糖蛋白抗体相关疾病诊断与治疗指南(2025版) [J]. 中华神经科杂志, 2025, 58(7): 704-720.
[2] Ambrosius, W., Michalak, S., Kozubski, W. and Kalinowska, A. (2020) Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Current Insights into the Disease Pathophysiology, Diagnosis and Management. International Journal of Molecular Sciences, 22, Article No. 100. [Google Scholar] [CrossRef] [PubMed]
[3] Jarius, S., Paul, F., Aktas, O., Asgari, N., Dale, R.C., de Seze, J., et al. (2018) MOG Encephalomyelitis: International Recommendations on Diagnosis and Antibody Testing. Journal of Neuroinflammation, 15, Article No. 134. [Google Scholar] [CrossRef] [PubMed]
[4] Sun, W., Xie, Y., Han, A., Zhou, X., Zhang, S., Xie, Y., et al. (2025) Clinical Characteristics and Factors Associated with Recurrence and Long-Term Prognosis in Patients with MOGAD. Frontiers in Immunology, 16, Article ID: 1535571. [Google Scholar] [CrossRef] [PubMed]
[5] 中华医学会儿科学分会神经学组, 复旦大学附属儿科医院复旦大学GRADE中心. 儿童髓鞘少突胶质细胞糖蛋白抗体相关疾病临床实践指南(2023) [J]. 中华儿科杂志, 2023, 61(11): 964-977.
[6] Al-Ani, A., Chen, J.J. and Costello, F. (2023) Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD): Current Understanding and Challenges. Journal of Neurology, 270, 4132-4150. [Google Scholar] [CrossRef] [PubMed]
[7] Langenbruch, L., Krämer, J., Güler, S., Möddel, G., Geßner, S., Melzer, N., et al. (2019) Seizures and Epilepsy in Multiple Sclerosis: Epidemiology and Prognosis in a Large Tertiary Referral Center. Journal of Neurology, 266, 1789-1795. [Google Scholar] [CrossRef] [PubMed]
[8] Yao, Y., Xu, Y., Ren, H., Zhou, X., Jin, L., Huang, Y., et al. (2019) Acute Epileptic Seizures in Myelin Oligodendrocyte Glycoprotein Encephalomyelitis and Neuromyelitis Optica Spectrum Disorder: A Comparative Cohort Study. Multiple Sclerosis and Related Disorders, 27, 281-288. [Google Scholar] [CrossRef] [PubMed]
[9] Shen, C., Zheng, Y., Cai, M., Yang, F., Fang, W., Zhang, Y., et al. (2020) Seizure Occurrence in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: A Systematic Review and Meta-Analysis. Multiple Sclerosis and Related Disorders, 42, Article ID: 102057. [Google Scholar] [CrossRef] [PubMed]
[10] 王瑶瑶, 孙一迪, 李怡萌, 等. 伴癫痫发作的髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体相关疾病患者临床特点及危险因素分析[J]. 中华神经科杂志, 2024, 57(6): 616-624.
[11] 李尚茹, 常旭婷, 张捷, 等. 儿童MOGAD中急性症状性癫痫发作及继发癫痫的相关因素分析[J]. 中华儿科杂志, 2024, 62(7): 655-660.
[12] Höftberger, R., Guo, Y., Flanagan, E.P., Lopez-Chiriboga, A.S., Endmayr, V., Hochmeister, S., et al. (2020) The Pathology of Central Nervous System Inflammatory Demyelinating Disease Accompanying Myelin Oligodendrocyte Glycoprotein Autoantibody. Acta Neuropathologica, 139, 875-892. [Google Scholar] [CrossRef] [PubMed]
[13] Takai, Y., Misu, T., Fujihara, K. and Aoki, M. (2023) Pathology of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: A Comparison with Multiple Sclerosis and Aquaporin 4 Antibody-Positive Neuromyelitis Optica Spectrum Disorders. Frontiers in Neurology, 14, Article ID: 1209749. [Google Scholar] [CrossRef] [PubMed]
[14] Sabatino, J.J., Pröbstel, A. and Zamvil, S.S. (2019) B Cells in Autoimmune and Neurodegenerative Central Nervous System Diseases. Nature Reviews Neuroscience, 20, 728-745. [Google Scholar] [CrossRef] [PubMed]
[15] de Curtis, M., Garbelli, R. and Uva, L. (2021) A Hypothesis for the Role of Axon Demyelination in Seizure Generation. Epilepsia, 62, 583-595. [Google Scholar] [CrossRef] [PubMed]
[16] Zeng, R., He, L., Kuang, Z., Jian, Y., Qiu, M., Liu, Y., et al. (2024) Clinical Characteristics, Immunological Alteration and Distinction of MOG-IgG-Associated Disorders and GFAP-IgG-Associated Disorders. Journal of Neuroimmunology, 393, Article ID: 578398. [Google Scholar] [CrossRef] [PubMed]
[17] 郑萍, 张含滋, 孙静, 等. 伴癫痫发作的儿童抗髓鞘少突胶质细胞糖蛋白抗体相关疾病的临床分析[J]. 中国实用儿科杂志, 2022, 37(8): 619-624.
[18] Rubin, M., Cutillo, G., Viti, V., Margoni, M., Preziosa, P., Zanetta, C., et al. (2025) MOGAD-Related Epilepsy: A Systematic Characterization of Age-Dependent Clinical, Fluid, Imaging and Neurophysiological Features. Journal of Neurology, 272, Article No. 508. [Google Scholar] [CrossRef] [PubMed]
[19] Foiadelli, T., Gastaldi, M., Scaranzin, S., Franciotta, D. and Savasta, S. (2020) Seizures and Myelin Oligodendrocyte Glycoprotein (MOG) Antibodies: Two Paradigmatic Cases and a Review of the Literature. Multiple Sclerosis and Related Disorders, 41, Article ID: 102011. [Google Scholar] [CrossRef] [PubMed]
[20] Ramanathan, S., O’grady, G.L., Malone, S., Spooner, C.G., Brown, D.A., Gill, D., et al. (2018) Isolated Seizures during the First Episode of Relapsing Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Demyelination in Children. Developmental Medicine & Child Neurology, 61, 610-614. [Google Scholar] [CrossRef] [PubMed]
[21] Zhong, X., Zhou, Y., Chang, Y., Wang, J., Shu, Y., Sun, X., et al. (2019) Seizure and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Encephalomyelitis in a Retrospective Cohort of Chinese Patients. Frontiers in Neurology, 10, Article No. 415. [Google Scholar] [CrossRef] [PubMed]
[22] Ogawa, R., Nakashima, I., Takahashi, T., Kaneko, K., Akaishi, T., Takai, Y., et al. (2017) MOG Antibody-Positive, Benign, Unilateral, Cerebral Cortical Encephalitis with Epilepsy. Neurology Neuroimmunology & Neuroinflammation, 4, e322. [Google Scholar] [CrossRef] [PubMed]
[23] Budhram, A., Mirian, A. and Sharma, M. (2022) Meningo-Cortical Manifestations of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Review of a Novel Clinico-Radiographic Spectrum. Frontiers in Neurology, 13, Article ID: 1044642. [Google Scholar] [CrossRef] [PubMed]
[24] Budhram, A., Mirian, A., Le, C., Hosseini-Moghaddam, S.M., Sharma, M. and Nicolle, M.W. (2019) Unilateral Cortical FLAIR-Hyperintense Lesions in Anti-MOG-Associated Encephalitis with Seizures (FLAMES): Characterization of a Distinct Clinico-Radiographic Syndrome. Journal of Neurology, 266, 2481-2487. [Google Scholar] [CrossRef] [PubMed]
[25] Montalvo, M., Khattak, J.F., Redenbaugh, V., Britton, J., Sanchez, C.V., Datta, A., et al. (2022) Acute Symptomatic Seizures Secondary to Myelin Oligodendrocyte Glycoprotein Antibody‐Associated Disease. Epilepsia, 63, 3180-3191. [Google Scholar] [CrossRef] [PubMed]
[26] Lotan, I., Chen, J.J., Hacohen, Y., Abdel-Mannan, O., Mariotto, S., Huda, S., et al. (2023) Intravenous Immunoglobulin Treatment for Acute Attacks in Myelin Oligodendrocyte Glycoprotein Antibody Disease. Multiple Sclerosis Journal, 29, 1080-1089. [Google Scholar] [CrossRef] [PubMed]
[27] Chen, J.J., Flanagan, E.P., Bhatti, M.T., Jitprapaikulsan, J., Dubey, D., Lopez Chiriboga, A.S., et al. (2020) Steroid-Sparing Maintenance Immunotherapy for MOG-IgG Associated Disorder. Neurology, 95, e111-e120. [Google Scholar] [CrossRef] [PubMed]

为你推荐