title: Acquired demyelinating disorders of childhood in the Western Cape, South Africa.
abstract: In a retrospective review of patients with acquired demyelinating disorders of the central nervous system, 19 children (0.6%) were identified from the Paediatric Neurology database of 3159 patients; 7 had acute disseminated encephalomyelitis, 1 had Schilder's disease, 5 had multiple sclerosis, and 6 had acute transverse myelitis. The median age of presentation was 83 months, with increased incidence during the summer and winter months. The commonest presentation was hemiparesis. The commonest regions of magnetic resonance imaging (MRI) abnormalities were the deep white matter (68%) and cerebellum (48%).The patients with multiple sclerosis had more monosymptomatic presentations (P < .02), raised cerebrospinal fluid protein (P = .022), and contrast enhancement of lesions (P = .05) compared with the acute disseminated encephalomyelitis group. Neuroepidemiological published surveillances of African children provide no data about these disorders. The prevalence of acquired demyelinating disorders in resource-poor settings is under-estimated because of the large burden of infections and limited access to neuroimaging.
authors.affiliation: Department of Paediatric Neurology, School of Child and Adolescent Health, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa. govenderr2@ukzn.ac.za
authors.forename: Rajeshree
authors.initials: R
authors.lastname: Govender
authors.forename: Nicky A
authors.initials: NA
authors.lastname: Wieselthaler
authors.forename: Alvin
authors.initials: A
authors.lastname: Ndondo
authors.forename: Jo M
authors.initials: JM
authors.lastname: Wilmshurst
mesh_terms: D017668:Age of Onset; D001921:Brain / Q000473:pathology; D002531:Cerebellum / Q000473:pathology; D002648:Child; D019992:Databases as Topic; D002549:Diffuse Cerebral Sclerosis of Schilder / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000473:pathology; D004673:Encephalomyelitis, Acute Disseminated / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000473:pathology; D009188:Myelitis, Transverse / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000473:pathology; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D010291:Paresis / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D012621:Seasons; D013019:South Africa / Q000453:epidemiology