Brain involvementĪcute disseminated encephalomyelitis (ADEM) is a common presenting clinical and imaging phenotype of patients with MOGAD, particularly in childhood 6. In contrast, less than half of adults presenting with MOGAD have brain lesions at the time of diagnosis. Nonetheless, certain imaging features are increasingly recognized as being more typical of MOGAD, allowing the diagnosis to be suspected on the basis of imaging. acute disseminated encephalomyelitis (ADEM), Neuromyelitis optica spectrum disorder (NMOSD) and to a lesser degree multiple sclerosis). Imaging presentation of MOGAD is variable and with no pathognomonic imaging features, with patients having an imaging phenotype often indistinguishable from other inflammatory white matter diseases of the central nervous system (e.g. Myelin oligodendrocyte glycoprotein is expressed on oligodendrocytes and the outer lamellae of myelin sheaths 6. No specific presentation distinguishes individuals with anti-MOG antibodies from those presenting with similar clinical manifestation but without the antibodies and at the time of writing (2020) no single set of diagnostic criteria are universally accepted 5. seizures - FLAIR-hyperintense lesions in anti-MOG associated encephalitis with seizures (FLAMES) 7Īdditionally, it appears that in approximately half of cases there is viral prodrome 2.longitudinally extensive spinal cord lesions (30%).Not all presentations are equally prevalent, however. Clinical presentationĬlinical presentation is that of other acquired demyelinating conditions and varies from individual to individual.
In children with acquired demyelination syndrome, MOG-IgGs are more commonly detected than aquaporin 4 antibodies 5.Īdditionally, children with anti-MOG associated encephalomyelitis are more likely to present with an ADEM-like clinical picture, whereas adults are more likely to present with an NMO-like syndrome 5. MOGAD is primarily encountered in children and young adults 1. Research in anti-MOG related diseases is rapidly evolving with new terminology being frequently proposed, including MOG-IgG-associated Optic Neuritis, Encephalitis, and Myelitis (MONEM), anti-MOG associated encephalomyelitis, anti-MOG encephalitis and other variations on this theme 1-4.
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