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The degree of immunosuppression employed varied depending on the complexity of each case and their response to treatment. Case 1 demonstrated significant improvement in visual acuity after a 5-day course of high-dose methylprednisolone. In contrast, Case 4 represented a starkly different outcome, where despite undergoing therapeutic plasmapheresis, the disease remained uncontrollable, ultimately leading to the child\u2019s unfortunate demise. Cases 2 and 3 involved patients with severe clinical conditions necessitating intensive care and mechanical ventilation. They exhibited a remarkable response to immunosuppressive therapy, gradually regaining neurological function.<\/jats:p>","DOI":"10.1136\/bcr-2023-259190","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T02:14:13Z","timestamp":1742955253000},"page":"e259190","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unravelling the clinical complexity of myelin oligodendrocyte glycoprotein antibody-associated acute disseminated encephalomyelitis in children: a comprehensive analysis"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6202-7642","authenticated-orcid":false,"given":"Pradeep","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sweta","family":"Sweta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giridhar","family":"Marithammanahalli Faneesha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anagha","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"2025082802054099000_18.3.e259190.1","first-page":"S38","article-title":"Acute disseminated encephalomyelitis","volume":"87","author":"Pohl","year":"2016","journal-title":"Neurology (ECronicon)"},{"key":"2025082802054099000_18.3.e259190.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000133048.75452.dd"},{"key":"2025082802054099000_18.3.e259190.3","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1212\/01.wnl.0000339482.84392.bd","article-title":"Incidence of acquired demyelination of the CNS in Canadian children","volume":"72","author":"Banwell","year":"2009","journal-title":"Neurology (ECronicon)"},{"key":"2025082802054099000_18.3.e259190.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.12.004"},{"key":"2025082802054099000_18.3.e259190.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004312"},{"key":"2025082802054099000_18.3.e259190.6","doi-asserted-by":"publisher","DOI":"10.1177\/1352458512466317"},{"key":"2025082802054099000_18.3.e259190.7","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-018-0112-x"},{"key":"2025082802054099000_18.3.e259190.8","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513484547"},{"key":"2025082802054099000_18.3.e259190.9","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.spen.2017.08.007","article-title":"The Spectrum of Inflammatory Acquired Demyelinating Syndromes in Children","volume":"24","author":"Neuteboom","year":"2017","journal-title":"Semin Pediatr Neurol"},{"key":"2025082802054099000_18.3.e259190.10","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1001\/jamaneurol.2019.2940","article-title":"Serial Anti-Myelin Oligodendrocyte Glycoprotein Antibody Analyses and Outcomes in Children With Demyelinating Syndromes","volume":"77","author":"Waters","year":"2020","journal-title":"JAMA Neurol"},{"key":"2025082802054099000_18.3.e259190.11","doi-asserted-by":"crossref","unstructured":"Hintzen RQ , Dale RC , Neuteboom RF , et al . 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