27th June 2023

Myelin-Oligodendrocyte-Glycoprotein Antibody-associated Disease

Myelin-Oligodendrocyte-Glycoprotein antibody associated disease (MOGAD) is another immune-mediated inflammatory disorder characterised by acute attacks of demyelination within the central nervous system. Like multiple sclerosis and NMOSD, this condition can be either relapsing-remitting or monophasic, although it primarily affects children rather than young adults. Clinical manifestations include the development of optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis (ADEM). ADEM presents with encephalopathy and multifocal neurological symptoms or signs. Anti-MOG immunoglobulin G (MOG-IgG) and MRI of the brain and spine are key to the diagnosis of MOGAD. High-dose intravenous steroids can be used for up to five days when an acute attack is diagnosed; however, there is limited scope for disease-modifying therapies as most patients present with a monophasic disease.