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Myelin Oligodendrocyte Glycoprotein MOG35-55 Induced Experimental Autoimmune Encephalomyelitis EAE in C57BL/6 Mice
Published on: April 15, 2014
Characteristics of myelin oligodendrocyte glycoprotein antibody-associated meningoencephalitis
Aisha Elfasi1,2, Samir Alkabie3,4, Elsa Rodriguez1,5
1Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA.
Background:
Meningoencephalitis can occur in myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD).
Objective:
To assess the clinical and radiologic features of MOG-IgG meningoencephalitis.
Methods:
Multicenter retrospective cases series of MOG-IgG meningoencephalitis and literature review of MOG-IgG-positive patients with the clinical syndrome of meningoencephalitis.
Results:
Ninety MOG-IgG-positive patients were identified from three academic medicine centers. 8/90 (8.9%) patients presented with a clinical syndrome of meningoencephalitis (age: 4-57 years; 5/8 male; 4/8 Caucasian; MOG-IgG titers 1:20-1:1000), which was the initial presentation in 7/8 patients. Symptoms included headaches (n = 8/8), encephalopathy (n = 7/8), seizures (n = 4/8), meningismus (n = 3/8), and aphasia (n = 3/8). Cerebrospinal fluid (CSF) pleocytosis was present in 7/8 patients (12-1745 cells/mm3) and frequently neutrophilic (>25%; n = 4/6). Magnetic resonance imaging (MRI) was notable for leptomeningeal enhancement with (n = 5/8) or without cortical edema (n = 1/8), focal dural enhancement (n = 1/8), and leptomeningeal loss of FLAIR suppression (n = 1/8). 7/8 patients sustained a relapsing disease course. Literature review identified 150 additional cases with MOG-IgG meningoencephalitis (initial attack in 86.7%) with median age of 20 (1-67) years, Asian (90.4%) and male (54.1%) predilection, and CSF pleocytosis in 87.9% of patients (82 [0-887] cells/cm3; ≥100 cells in 44.3%), which was frequently (51.7%) neutrophilic.
Conclusions:
MOG-IgG meningoencephalitis may represent the initial presentation of MOGAD with neutrophilic pleocytosis in CSF and meningo-cortical involvement on MRI.
Insights
Meningoencephalitis can be the first sign of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). This condition often presents with central nervous system inflammation, including in the meninges and brain, and may recur.
Area of Science:
- Neurology
- Immunology
- Neuroimmunology
Background:
- Meningoencephalitis, an inflammation of the brain and meninges, can be a manifestation of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).
- Understanding the characteristics of MOGAD-related meningoencephalitis is crucial for accurate diagnosis and management.
Purpose of the Study:
- To investigate the clinical and radiological features of meningoencephalitis in patients with MOG antibody-associated disease (MOGAD).
- To characterize the presentation, symptoms, cerebrospinal fluid findings, and neuroimaging in MOG-IgG meningoencephalitis.
Main Methods:
- A multicenter retrospective case series involving MOG-IgG-positive patients diagnosed with meningoencephalitis.
- A comprehensive literature review was conducted to identify and analyze additional cases of MOG-IgG meningoencephalitis.
Main Results:
- Eight of ninety MOG-IgG-positive patients presented with meningoencephalitis, often as the initial symptom.
- Common symptoms included headache, encephalopathy, and seizures, with cerebrospinal fluid analysis frequently showing neutrophilic pleocytosis.
- Neuroimaging revealed leptomeningeal enhancement and sometimes cortical edema, with a tendency for relapsing disease course.
Conclusions:
- Meningoencephalitis can be an initial presentation of MOGAD.
- Findings suggest meningo-cortical involvement and neutrophilic pleocytosis in cerebrospinal fluid are characteristic.
- This highlights the importance of considering MOGAD in cases of meningoencephalitis with these features.
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