Patients with neuroinflammatory disorders may have persistent cognitive sequelae. Certain presentations, such as acute disseminated encephalomyelitis (ADEM) and encephalitis, can be more associated with cognitive deficits. However, detailed neuropsychological data are still limited in the pediatric population, where pathology and developmental processes interact.

A retrospective chart review of 21 pediatric patients (age ≤ 19) with neuroinflammatory disorders with brain involvement who received neuropsychological evaluation between 2022-2025 was performed. Patients diagnosed with myelin oligodendrocyte glycoprotein antibody disease (MOGAD; n = 9), pediatric-onset multiple sclerosis (POMS; n = 5), seronegative ADEM (n = 3), autoimmune encephalitis (n = 2), and neuromyelitis optica spectrum disorder (n = 2) were included. Domains assessed included intellectual functioning, language, attention, working memory, processing speed, speeded fine motor dexterity, executive functioning, and verbal memory.

Standard scores were calculated. Descriptive statistical analyses were performed; secondary analyses were conducted to explore differences between the MOGAD and POMS subgroups.

The sample was predominantly female (71%) with a mean age of 13.58 years (SD = 3.86).  As a group, cognitive functioning across domains was average with isolated weaknesses in processing speed (M = 85.81, SD = 12.95) and speeded fine motor dexterity (M = 74.22, SD = 25.40). Within the POMS subgroup, memory was an additional area of weakness. Within the MOGAD subgroup, attention, working memory, and executive functioning were additional areas of weakness. The MOGAD subgroup had lower working memory than the POMS subgroup (p = 0.04)

Our results show largely intact neuropsychological function in this sample with isolated weakness in cognitive and fine motor speed. Subgroup differences were observed, suggesting both common and distinct features of cognitive impairment between disorders. Further study is needed to explore differences between subgroups and identify factors predictive of cognitive outcomes.