Atypical Anti-MOG syndrome with aseptic meningoencephalitis and pseudotumor cerebri-like presentations

Ram N. Narayan, Cynthia Wang, Peter Sguigna, Khalil Husari, Benjamin Greenberg

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe 2 atypical cases with Anti-MOG antibody related demyelinating syndrome. Methodology: Case series. Results: We present two cases. Case 1 is an 18-year-old woman who presented with headache, blurred vision, and papilledema and was initially diagnosed with pseudotumor cerebri syndrome. CSF showed mildly elevated opening pressure and lymphocytic pleocytosis and a diagnosis of aseptic meningitis was considered. MRI brain and spinal cord revealed longitudinally extensive bilateral simultaneous optic neuritis and multiple spinal cord lesions. Case 2 is a 28-year old man who presented initially with unilateral optic neuritis followed by aseptic meningitis three weeks later and subsequently acute disseminated encephalomyelitis (ADEM). Serology was positive for Anti-MOG antibody on a cell-based assay in both these cases. Discussion: Although bilateral optic neuritis has been well described in MOG related disorders, aseptic meningitis and pseudotumor cerebri-like syndromes are notable alternate presentations. The presence of eosinophils in the CSF (in the first patient) is a unique finding in our case series. Conclusion: In a patient with an aseptic meningitis like presentation, the presence of optic neuritis, brain and/or spinal cord lesions should raise suspicion for an MOG-Ab related syndrome.

Original languageEnglish (US)
Pages (from-to)30-33
Number of pages4
JournalMultiple Sclerosis and Related Disorders
Volume27
DOIs
StatePublished - Jan 2019

Keywords

  • Aseptic meningoencphalitis
  • MOG
  • Myelin oligodendrocyte glycoprotein

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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