Treatment strategies are still being optimized, although early intervention may not necessarily alter the clinical course (Rudnick et al. 2001a; Mitchell et al. 2002) (Table 13.3). Early treatment guided by CSF lymphocyte immunophenotyping as performed at the National Pediatric Myoclonus Center (Pranzatelli et al. 1998a, 2002b) may improve outcome. In that approach, an attempt is made to achieve fast and complete neurologic remission using immunologic markers as surrogates for disease monitoring. Children with OMS may require long-term therapy.

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