[Disease associated with anti-myelin oligodendrocyte glycoprotein (MOGAD)]

The disease associated with antibodies against myelin oligodendrocyte glycoprotein (MOGAD) is an inflammatory demyelinating disorder of the central nervous system. The clinical phenotype is diverse and varies according to the age at presentation, with acute disseminated encephalomyelitis (ADEM) in children, and optic neuritis and transverse myelitis more frequently observed in adults. Detection of anti-MOG antibodies is required for diagnosis. Testing for antibodies using serum cell-based assays (CBA) is the method of choice. Diagnosis is made based on the clinical presentation associated with antibody positivity and the exclusion of more likely alternative diagnoses. Acute management includes intravenous methylprednisolone (IVMP) for 3-5 days, followed by oral corticosteroids with a gradual taper over the 3 months following the acute event. If there is inadequate response, intravenous immunoglobulin (IVIG) or plasma exchange may be initiated as second-line therapy. Maintenance treatment is reserved for patients who experience relapses or have a severe initial presentation with poor recovery.