A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis

Katharina Blunschi; Pallavi Avasarala; John Schreiber; Neha Athale; Ilana Kahn; Tarannum Lateef

doi:doi:10.11648/j.cnn.20210502.15

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A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis

Katharina Blunschi, Pallavi Avasarala, John Schreiber, Neha Athale, Ilana Kahn, Tarannum Lateef

Published in Clinical Neurology and Neuroscience (Volume 5, Issue 2)

Received: 5 April 2021 Accepted: 11 May 2021 Published: 27 May 2021

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Abstract

Childhood absence epilepsy (CAE) is one of the most common forms of pediatric epilepsy. While most patients become seizure free with anti-epileptic drug therapy approximately 20% do not achieve seizure remission and are defined as having refractory CAE. Epilepsy is generally thought of as a grey matter disease but has also been associated with abnormal white matter. Optic neuritis (ON), on the other hand, is typically a white matter disorder characterized by inflammation and demyelination of the myelin sheath due to autoantibodies, such as the anti-myelin oligodendrocyte glycoprotein (MOG) antibody. We present the case of an 11-year-old female with refractory CAE who developed anti-MOG antibody positive ON. CAE and ON are not commonly co-morbid and to our knowledge their co-occurrence in a patient has not been previously described. However, in this case, the CAE and ON may be related as her seizures dramatically improved after initiating immunomodulatory treatments for the ON. This may indicate a relationship between ON (potentially specific to anti-MOG positive ON) and CAE, or may suggest that there is an inflammatory component to CAE and that immunomodulatory therapies may have a role in seizure control. Thus, in cases of treatment resistant absence epilepsy, an immune work up may be helpful.

Published in	Clinical Neurology and Neuroscience (Volume 5, Issue 2)
DOI	10.11648/j.cnn.20210502.15
Page(s)	25-29
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Seizure, Childhood Absence Epilepsy, Neuroinflammation, Demyelination

References

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APA Style

Katharina Blunschi, Pallavi Avasarala, John Schreiber, Neha Athale, Ilana Kahn, et al. (2021). A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis. Clinical Neurology and Neuroscience, 5(2), 25-29. https://doi.org/10.11648/j.cnn.20210502.15

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ACS Style

Katharina Blunschi; Pallavi Avasarala; John Schreiber; Neha Athale; Ilana Kahn, et al. A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis. Clin. Neurol. Neurosci. 2021, 5(2), 25-29. doi: 10.11648/j.cnn.20210502.15

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AMA Style

Katharina Blunschi, Pallavi Avasarala, John Schreiber, Neha Athale, Ilana Kahn, et al. A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis. Clin Neurol Neurosci. 2021;5(2):25-29. doi: 10.11648/j.cnn.20210502.15

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@article{10.11648/j.cnn.20210502.15,
  author = {Katharina Blunschi and Pallavi Avasarala and John Schreiber and Neha Athale and Ilana Kahn and Tarannum Lateef},
  title = {A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis},
  journal = {Clinical Neurology and Neuroscience},
  volume = {5},
  number = {2},
  pages = {25-29},
  doi = {10.11648/j.cnn.20210502.15},
  url = {https://doi.org/10.11648/j.cnn.20210502.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20210502.15},
  abstract = {Childhood absence epilepsy (CAE) is one of the most common forms of pediatric epilepsy. While most patients become seizure free with anti-epileptic drug therapy approximately 20% do not achieve seizure remission and are defined as having refractory CAE. Epilepsy is generally thought of as a grey matter disease but has also been associated with abnormal white matter. Optic neuritis (ON), on the other hand, is typically a white matter disorder characterized by inflammation and demyelination of the myelin sheath due to autoantibodies, such as the anti-myelin oligodendrocyte glycoprotein (MOG) antibody. We present the case of an 11-year-old female with refractory CAE who developed anti-MOG antibody positive ON. CAE and ON are not commonly co-morbid and to our knowledge their co-occurrence in a patient has not been previously described. However, in this case, the CAE and ON may be related as her seizures dramatically improved after initiating immunomodulatory treatments for the ON. This may indicate a relationship between ON (potentially specific to anti-MOG positive ON) and CAE, or may suggest that there is an inflammatory component to CAE and that immunomodulatory therapies may have a role in seizure control. Thus, in cases of treatment resistant absence epilepsy, an immune work up may be helpful.},
 year = {2021}
}

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TY  - JOUR
T1  - A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis
AU  - Katharina Blunschi
AU  - Pallavi Avasarala
AU  - John Schreiber
AU  - Neha Athale
AU  - Ilana Kahn
AU  - Tarannum Lateef
Y1  - 2021/05/27
PY  - 2021
N1  - https://doi.org/10.11648/j.cnn.20210502.15
DO  - 10.11648/j.cnn.20210502.15
T2  - Clinical Neurology and Neuroscience
JF  - Clinical Neurology and Neuroscience
JO  - Clinical Neurology and Neuroscience
SP  - 25
EP  - 29
PB  - Science Publishing Group
SN  - 2578-8930
UR  - https://doi.org/10.11648/j.cnn.20210502.15
AB  - Childhood absence epilepsy (CAE) is one of the most common forms of pediatric epilepsy. While most patients become seizure free with anti-epileptic drug therapy approximately 20% do not achieve seizure remission and are defined as having refractory CAE. Epilepsy is generally thought of as a grey matter disease but has also been associated with abnormal white matter. Optic neuritis (ON), on the other hand, is typically a white matter disorder characterized by inflammation and demyelination of the myelin sheath due to autoantibodies, such as the anti-myelin oligodendrocyte glycoprotein (MOG) antibody. We present the case of an 11-year-old female with refractory CAE who developed anti-MOG antibody positive ON. CAE and ON are not commonly co-morbid and to our knowledge their co-occurrence in a patient has not been previously described. However, in this case, the CAE and ON may be related as her seizures dramatically improved after initiating immunomodulatory treatments for the ON. This may indicate a relationship between ON (potentially specific to anti-MOG positive ON) and CAE, or may suggest that there is an inflammatory component to CAE and that immunomodulatory therapies may have a role in seizure control. Thus, in cases of treatment resistant absence epilepsy, an immune work up may be helpful.
VL  - 5
IS  - 2
ER  -

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Author Information

Katharina Blunschi

Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
Pallavi Avasarala

Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
John Schreiber

Department of Neurology, Children’s National Health System and George Washington University School of Medicine, Washington D. C., USA
Neha Athale

Department of Neurology, Children’s National Health System and George Washington University School of Medicine, Washington D. C., USA
Ilana Kahn

Department of Neurology, Children’s National Health System and George Washington University School of Medicine, Washington D. C., USA
Tarannum Lateef

Department of Neurology, Children’s National Health System and George Washington University School of Medicine, Washington D. C., USA

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APA Style

Katharina Blunschi, Pallavi Avasarala, John Schreiber, Neha Athale, Ilana Kahn, et al. (2021). A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis. Clinical Neurology and Neuroscience, 5(2), 25-29. https://doi.org/10.11648/j.cnn.20210502.15

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ACS Style

Katharina Blunschi; Pallavi Avasarala; John Schreiber; Neha Athale; Ilana Kahn, et al. A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis. Clin. Neurol. Neurosci. 2021, 5(2), 25-29. doi: 10.11648/j.cnn.20210502.15

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AMA Style

Katharina Blunschi, Pallavi Avasarala, John Schreiber, Neha Athale, Ilana Kahn, et al. A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis. Clin Neurol Neurosci. 2021;5(2):25-29. doi: 10.11648/j.cnn.20210502.15

Copy | Download

@article{10.11648/j.cnn.20210502.15,
  author = {Katharina Blunschi and Pallavi Avasarala and John Schreiber and Neha Athale and Ilana Kahn and Tarannum Lateef},
  title = {A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis},
  journal = {Clinical Neurology and Neuroscience},
  volume = {5},
  number = {2},
  pages = {25-29},
  doi = {10.11648/j.cnn.20210502.15},
  url = {https://doi.org/10.11648/j.cnn.20210502.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20210502.15},
  abstract = {Childhood absence epilepsy (CAE) is one of the most common forms of pediatric epilepsy. While most patients become seizure free with anti-epileptic drug therapy approximately 20% do not achieve seizure remission and are defined as having refractory CAE. Epilepsy is generally thought of as a grey matter disease but has also been associated with abnormal white matter. Optic neuritis (ON), on the other hand, is typically a white matter disorder characterized by inflammation and demyelination of the myelin sheath due to autoantibodies, such as the anti-myelin oligodendrocyte glycoprotein (MOG) antibody. We present the case of an 11-year-old female with refractory CAE who developed anti-MOG antibody positive ON. CAE and ON are not commonly co-morbid and to our knowledge their co-occurrence in a patient has not been previously described. However, in this case, the CAE and ON may be related as her seizures dramatically improved after initiating immunomodulatory treatments for the ON. This may indicate a relationship between ON (potentially specific to anti-MOG positive ON) and CAE, or may suggest that there is an inflammatory component to CAE and that immunomodulatory therapies may have a role in seizure control. Thus, in cases of treatment resistant absence epilepsy, an immune work up may be helpful.},
 year = {2021}
}

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TY  - JOUR
T1  - A Case of Refractory Absence Epilepsy Precedes Anti-MOG Associated Optic Neuritis
AU  - Katharina Blunschi
AU  - Pallavi Avasarala
AU  - John Schreiber
AU  - Neha Athale
AU  - Ilana Kahn
AU  - Tarannum Lateef
Y1  - 2021/05/27
PY  - 2021
N1  - https://doi.org/10.11648/j.cnn.20210502.15
DO  - 10.11648/j.cnn.20210502.15
T2  - Clinical Neurology and Neuroscience
JF  - Clinical Neurology and Neuroscience
JO  - Clinical Neurology and Neuroscience
SP  - 25
EP  - 29
PB  - Science Publishing Group
SN  - 2578-8930
UR  - https://doi.org/10.11648/j.cnn.20210502.15
AB  - Childhood absence epilepsy (CAE) is one of the most common forms of pediatric epilepsy. While most patients become seizure free with anti-epileptic drug therapy approximately 20% do not achieve seizure remission and are defined as having refractory CAE. Epilepsy is generally thought of as a grey matter disease but has also been associated with abnormal white matter. Optic neuritis (ON), on the other hand, is typically a white matter disorder characterized by inflammation and demyelination of the myelin sheath due to autoantibodies, such as the anti-myelin oligodendrocyte glycoprotein (MOG) antibody. We present the case of an 11-year-old female with refractory CAE who developed anti-MOG antibody positive ON. CAE and ON are not commonly co-morbid and to our knowledge their co-occurrence in a patient has not been previously described. However, in this case, the CAE and ON may be related as her seizures dramatically improved after initiating immunomodulatory treatments for the ON. This may indicate a relationship between ON (potentially specific to anti-MOG positive ON) and CAE, or may suggest that there is an inflammatory component to CAE and that immunomodulatory therapies may have a role in seizure control. Thus, in cases of treatment resistant absence epilepsy, an immune work up may be helpful.
VL  - 5
IS  - 2
ER  -

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