![]() Neurodiagnostically, patterns have emerged to distinguish this disorder from other demyelinating diseases. Most studies have found a bimodal distribution of clinical phenotypes, with younger patients predominantly presenting with ADEM and older children presenting with optic neuritis. The most common clinical phenotype of MOG-antibody associated disorders in children is ADEM, followed by optic neuritis and transverse myelitis. The precise function of MOG is poorly understood however, it likely plays a role in myelin maturation, myelin integrity, and cell surface interactions. ![]() MOG is a myelin glycoprotein that is exclusively expressed in the central nervous system and has been identified in about one-third of children diagnosed with an acquired demyelinating syndrome (ADS). MOG-antibody associated disease is an emerging demyelinating disorder that is characterized by a broad range of clinical phenotypes and neuroimaging findings with a disease course that is distinct from multiple sclerosis (MS). The combination of subacute encephalopathy with ataxia and hyperreflexia, neuro-imaging consistent with a demyelinating process, and serum MOG-antibody positivity led to the diagnosis of MOG-antibody associated encephalomyelitis. Serum antibodies to myelin oligodendrocyte glycoprotein (MOG) were reported positive after the patient was discharged. She was treated with high-dose intravenous steroids followed by a steroid taper leading to significant clinical improvement. The differential diagnosis included acute disseminated encephalomyelitis (ADEM), neuromyelitis optica (NMO), viral encephalomyelitis, and anti-NMDA receptor encephalitis. MRI of the brain and spine revealed diffuse patchy areas of abnormal signal in the cerebral peduncles, bilateral thalami, and cortical/subcortical areas bilaterally (Figure 3 A-C) and a longitudinally extensive spinal cord lesion from C2-T2, as well as involvement of the conus medullaris (Figure 3 D) - all suggestive of an inflammatory process.įigure 3 (above): MRI of the brain and spine T2 Axial FLAIR imaging demonstrating bilateral cortical T2 hyperintensities (A), left thalamic T2 hyperintensity (B), bilateral cerebral peduncle hyperintensities (C), and spinal imaging revealing a longitudinally extensive lesion predominantly affecting the grey matter from C2-T2 (D) ![]() A lumbar puncture showed an elevated white blood cell count of 225 (lymphocytic predominance), red blood cell count of 56, elevated protein of 55, and normal glucose. Her neurologic exam was notable for meningismus, hyperreflexia, bilateral sustained ankle clonus, dysmetria, and ataxia. Over the course of 3 weeks prior to hospitalization, her mother noticed a change in her gait and behavior in addition to episodes of headaches and emesis, which seemed to begin after a minor trauma.įigure 3 (A-D clockwise starting in upper left) During her hospitalization, she became increasingly agitated, with episodes of increased sleepiness, prompting neurologic consultation for encephalopathy. 5-year-old female with history of behavioral issues, constipation, and mild developmental delays presents for medical evaluation of headaches, gait abnormality, generalized weakness, and weight loss. Neurological update: MOG antibody disease. living-with-myelitis/disease-information/mog-antibody-disease/ patient-guide/leaflets/files/45339Pmog.pdf MOG antibody demyelination: Information for patients.Emerging drugs for the treatment of adult MOG-IgG-associated diseases. Clinical features and risk of relapse in children and adults with myelin oligodendrocyte glycoprotein antibody-associated disease. Myelin oligodendrocyte glycoprotein antibody-associated disease: Current insights into the disease pathophysiology, diagnosis, and management. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. muscle weakness or paralysis, particularly in the arms and legsĪcute disseminated encephalomyelitis (ADEM)ĪDEM is an inflammatory condition that affects the brain.abnormal sensations, which can include feelings of numbness and tingling (“pins and needles”) and extreme sensitivity to touch.The exact symptoms of transverse myelitis can vary depending on which part of the spinal cord is affected. Transverse myelitis is when inflammation affects the spinal cord. eye pain, particularly when moving your eye. ![]() This nerve transmits signals between your eyes and your brain. Optic neuritis is inflammation of the optic nerve. It’s been associated with the following conditions: Optic neuritis MOGAD can affect parts of the nervous system like the optic nerve, spinal cord, and brain. ![]()
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