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

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.

authors

Narayan RN,Wang C,Sguigna P,Husari K,Greenberg B

doi

10.1016/j.msard.2018.10.003

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

30-33

eissn

2211-0348

issn

2211-0356

pii

S2211-0348(18)30365-1

journal_volume

27

pub_type

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