Four cases of MOG antibody-associated disease with cortical encephalitis as the main manifestation and review of the literature
Objective We report four cases of myelin oligodendrocyte glycoprotein(MOG)antibody-associated dis-ease(MOG-AD)with cortical encephalitis as the main manifestation.We analyse the clinical features and relevant ancil-lary tests,and review the literature in order to provide a reference basis for the proper clinical management of this disease.Methods The clinical manifestations,cerebrospinal fluid cytology,imaging,treatment and prognosis of four patients with MOG-AD with cortical encephalitis as the main manifestation,admitted to the Department of Neurology of the Affili-ated Hospital of Jining Medical University from October 2020 to February 2023,were retrospectively analyzed.The anti-MOG antibodies were detected by a cell-based assay(CBA).Results The four patients in this paper were aged 16-32 years and all presented with cortical encephalitis.Three of them started with seizures and one presented with his first sei-zure 15 d after headache and fever.The cranial MRI showed thickening of brain tissue in the cortical area and multiple ab-normal signal shadows in the sulcal pools,with relatively high signal on FLAIR images.Serum anti-MOG antibody tests were positive.The patients were treated with hormones and/or immunoglobulin and discharged,with two patients experi-encing relapses.Conclusion MOG-AD can have a predominantly cortical encephalitis phenotype,presenting with head-ache,fever and seizures.The initial diagnosis is easily made as"infective meningoencephalitis or meningitis",and cra-nial MRI often shows unilateral or bilateral cortical swelling;immunotherapy is effective,but some patients may experi-ence recurrence;for patients with cortical encephalitis who are poorly treated with anti-infective therapy,the disease needs to be alerted,and a"positive"serum MOG-IgG test can clarify the diagnosis.
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