Abstract
A 7-year-old girl developed sudden-onset right-faciobrachial hemiparesis after 3-month period of progressive abnormal behavior and academic impairment without encephalopathy. Brain MRI at diagnosis showed an extensive and confluent bilateral white matter involvement and gadolinium enhancement ([Fig. 1]). Metabolic and infectious studies were negative. The CSF profile showed mild pleocytosis and oligoclonal-bands were negative. Serum autoantibodies against myelin-oligodendrocyte-glycoprotein (MOG-abs) were 1/1,280 at onset. After early treatment with intravenous methylprednisolone and rituximab, her motor function fully recovered. After 12-months follow-up, mild cognitive and visuospatial deficits persist and MOG-abs were 1/640. No relapses have occurred.
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