Neuroinflammatory and demyelinating disorders in children: demystifying and updating with a focus on myelin oligodendrocyte glycoprotein antibody-associated disease

Pediatric neuroinflammatory disorders are a heterogeneous group of autoimmune conditions that have evolved rapidly over the past decade and are encountered in both community and specialized pediatric practice. This group can share overlapping features and includes pediatric-onset multiple sclerosis (POMS), acute disseminated encephalomyelitis (ADEM), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), formally defined by international consensus in 2023 [32]. Advances in imaging techniques, international consensus statements, and improved detection of central nervous system (CNS)-specific autoantibodies have enabled prompt, precise diagnosis of these disorders [2]. Magnetic resonance imaging (MRI) is an essential tool for early identification, differentiation, and diagnosis, enabling early intervention and focused treatment. This review provides an up-to-date clinico-radiological summary of pediatric-onset multiple sclerosis (POMS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), emphasizing MRI protocols and advanced sequences for lesion detection and phenotypic differentiation.