MOGAD update: new phenotypes in the expanding clinical spectrum

Myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) is often heralded by established clinical features, including optic neuritis (ON), transverse myelitis (TM), cerebral cortical encephalitis, acute disseminated encephalitis (ADEM), and cerebral, brainstem and/or cerebellar defects. Recent publications have revealed new clinical phenotypes that challenge perceptions regarding age of onset, disease progression, and neurologic recovery related to MOGAD relapses. In this review, we use a case-based format to highlight less typical disease manifestations of MOGAD that will likely gain more recognition over time. In so doing, we hope to facilitate earlier diagnosis and more impactful treatment for people with MOGAD (pwMOGAD). Further scientific exploration regarding less common clinical manifestations of MOGAD may inform understanding regarding pathogenicity of the MOG autoantibody, and pathobiological mechanisms that drive disease expression in this intriguing condition.