PhD defence A.L. (Arlette) Bruijstens

Summary:

Acquired demyelinating syndromes (ADS) encompass a wide and constantly evolving spectrum of immune-mediated disorders of the central nervous system (CNS). The first clinical attack may be the only episode patients will ever experience, if it represents a monophasic disorder included under the umbrella term ADS. However, this attack may also be the first presentation of a relapsing potentially disabling inflammatory disease like multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD). Because of overlapping features, separation of the ADS at onset of disease can be challenging. However, early diagnosis and accurate prediction of disease course is crucial for adequate patient management, including correct counseling of patients and/or their families. Further understanding of pathophysiology and prognosis of the different ADS will add to an earlier and more accurate delineation of the distinctive disorders within the ADS spectrum. Compared to adult-onset MS, our knowledge about pediatric-onset MS is limited. The same accounts for the ADS variants associated with autoantibodies, both in children and adults. Therefore, this thesis focuses on the cause and course of ADS, with special focus on pediatric-onset MS in part I and antibody-associated disorders in children and adults in part II.