Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD)
Presentation
Cough for two weeks, with a fever for the past two days. Admitted to the hospital due to the inability to urinate. During the stay in the emergency room, severe dizziness occurred. Neurological consultation revealed palsy of the sixth nerve and balance disturbances. It was decided to perform a head MRI examination.
Patient Data
Additionally, within the white matter of the brain, multiple focal areas of elevated T2/FLAIR signal are visible, showing an increase ADC values without contrast enhancement: in the right occipital lobe, periventricularly (near the posterior horn of the lateral ventricle), in the right parietal lobe subcortically and within the centrum semiovale, in the left parietal lobe within the centrum semiovale and in the left hemisphere of the cerebellum.
Furthermore, the examination reveals a long segmental elevation of the signal in the cervical spinal cord.
Case Discussion
Multifocal changes in the white matter and within the spinal cord suggest a demyelinating process. The predilection of these changes for the brainstem and the long segmental change in the spinal cord strongly indicate a probable diagnosis of MOGAD (MOG antibody-associated disorder). Cerebrospinal fluid examination revealed the presence of anti-MOG antibodies, confirming the diagnosis.
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