The Varying Faces of MOGAD: A Case Series

Myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG)-associated disease (MOGAD) is an immune mediated demyelinating disorder initially described as a subtype of neuromyelitis optica spectrum disorder with antibodies against MOG. Recently, it has been described as a separate disease entity with unique clinical and radiological features. We herein report the clinical details of eight MOG-IgG-positive patients to highlight the peculiar and varied clinical and radiological features of this condition. Encephalitis was the most common presenting feature in our study, especially in pediatric cases. Tremors and parkinsonism were noted in four cases, of which one was a child. Monophasic course was noted in seven patients. Relapsing course was noted only in a single patient who was initiated on immunosuppressants. The clinical pictures highlight the importance of screening for anti-MOG in individuals with encephalitic and multiaxial symptoms in spite of having normal imaging. Acute demyelinating encephalomyelitis such as imaging features in the pediatric age group may also be a consideration for MOG testing.