Residual disability develops in 50-80% of patients, with transverse myelitis at onset being the most significant predictor of long-term outcome. Disease course can be either monophasic or relapsing, with subsequent relapses most commonly involving the optic nerve. Although no age group is exempt, median age of onset is within the fourth decade of life, with optic neuritis being the most frequent presenting phenotype. S2CID 37354295.Myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOG-AD) is now recognised as a nosological entity with specific clinical and paraclinical features to aid early diagnosis.
"Long survival and clinical stability in Marburg's variant multiple sclerosis". ^ Turatti, Marco Gajofatto, Alberto Rossi, Francesca Vedovello, Marcella Benedetti, Maria Donata (2010).Harrison's principles of internal medicine (18th ed.). "Rituximab induces clinical stabilization in a patient with fulminant multiple sclerosis not responding to natalizumab". "Autologous stem-cell transplantation in malignant multiple sclerosis: A case with a favorable long-term outcome". 16th Meeting of the European Neurological Society. "Alemtuzumab and craniotomy for severe acute demyelinating illness". "Treatment of Marburg Variant Multiple Sclerosis with Mitoxantrone". "Marburg type and Balò's concentric sclerosis: rare and acute variants of multiple sclerosis".
^ Capello E, Mancardi GL (November 2004).Kermode Wei Qiu, Brain histopathological study and prognosis in MOG antibody‐associated demyelinating pseudotumor, 08 January 2019, ^ Yaqing Shu Youming Long Shisi Wang Wanming Hu Jian Zhou Huiming Xu Chen Chen Yangmei Ou Zhengqi Lu Alexander Y.A case report, Multiple Sclerosis and Related Disorders, Volume 31, June 2019, Pages 51-53, ^ Eduardo Labat et al., An extremely aggressive case of Marburg's disease treated with high dose cyclophosphamide.^ Todd A Hardy, Reddel, Barnett, Palace, Lucchinetti, Weinshenker, Atypical CNS inflammatory demyelinating disease, The lancet neurology, August, 2016, DOI: (16)30043-6, Manuscript Number: THELANCETNEUROLOGY-D-16-00113R1 available at."Defining the clinical course of multiple sclerosis: Results of an international survey". "Les formes frontières de sclérose en plaques". However, there are some reports of Marburg MS reaching stability by three years. Marburg variant of MS is an acute fulminant demyelinating process which in most cases progresses inexorably to death within 1–2 years.
For patients who survive the acute attack, follow-up treatments include immunosuppression (monthly mitoxantrone or cyclophosphamide) either alone or in combination with IFN beta or GA ( glatiramer acetate). Treatment recommendations, based on anecdotes, include plasma exchange in conjunction with high-dose glucocorticoids(e.g., 1 to 2 g/day of methylprednisolone for 10 days followed by a slow taper). Historically, acute MS was a fatal disease, with death occurring within a year of onset, often secondary to extensive brain stem demyelination. Recent evidence shows that Marburg's presents a heterogeneous response to medication, as does standard MS. It is usually lethal, but it has been found to be responsive to Mitoxantrone and Alemtuzumab, and it has also been responsive to autologous stem cell transplantation. If Marburg disease occurs in the form of a single large lesion, it can be radiologically indistinguishable from a brain tumor or abscess. It can be diagnosed in vivo with an MRI scan. After the discovery of the anti-MOG disease this classification is into revision. Some anti-MOG cases satisfy the MS requirements (lesions disseminated in time and space) and are therefore traditionally considered MS cases. Main article: anti-MOG associated encephalomyelitis