Cranial nerve involvement in patients with MOG antibody–associated disease

Cobo‐Calvo, Álvaro; Ayrignac, Xavier; Kerschen, Philippe; Horellou, Philippe; Cotton, François; Labauge, Pierre; Vukusic, Sandra; Deiva, Kumaran; Serguera, Ché; Marignier, Romain

doi:10.1212/nxi.0000000000000543

Cited by 61 publications

(41 citation statements)

References 36 publications

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“…Interestingly, for MOG-antibody-associated disease, besides NMO phenotype, optic neuritis, and myelitis, some of these MOG-antibody-positive cases also have clinical phenotypes beyond the current NMOSD spectrum, such as ADEM/MDEM-like presentation ( 71 ), cerebral cortical encephalitis ( 12 ), and cranial nerve involvement ( 14 ). Pathologically, MOG-antibody-associated disease is a type of demyelinating disease, as opposed to astrocytopathic disease seen in AQP4-antibody-positive NMOSD ( 72 , 73 ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Neuromyelitis Optica Spectrum Disorder and Its Prevalence and Incidence Worldwide

Hor¹,

et al. 2020

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Neuromyelitis optica spectrum disorder (NMOSD) is an uncommon inflammatory disease of the central nervous system, manifesting clinically as optic neuritis, myelitis, and certain brain and brainstem syndromes. Cases clinically diagnosed as NMOSD may include aquaporin 4 (AQP4)-antibody-seropositive autoimmune astrocytopathic disease, myelin oligodendrocyte glycoprotein (MOG)-antibody-seropositive inflammatory demyelinating disease, and double-seronegative disease. AQP4-antibody disease has a high female-to-male ratio (up to 9:1), and its mean age at onset of ~40 years is later than that seen in multiple sclerosis. For MOG-antibody disease, its gender ratio is closer to 1:1, and it is more common in children than in adults. Its clinical phenotypes differ but overlap with those of AQP4-antibody disease and include acute disseminated encephalomyelitis, brainstem and cerebral cortical encephalitis, as well as optic neuritis and myelitis. Double-seronegative disease requires further research and clarification. Population-based studies over the past two decades report the prevalence and incidence of NMOSD in different populations worldwide. One relevant finding is the varying prevalence observed in different racial groups. Consistently, the prevalence of NMOSD among Whites is ~1/100,000 population, with an annual incidence of <1/million population. Among East Asians, the prevalence is higher, at ~3.5/100,000 population, while the prevalence in Blacks may be up to 10/100,000 population. For MOG-antibody disease, hospital-based studies largely do not observe any significant racial preponderance so far. This disorder comprises a significant proportion of NMOSD cases that are AQP4-antibody-seronegative. A recent Dutch nationwide study reported the annual incidence of MOG-antibody disease as 1.6/million population (adult: 1.3/million, children: 3.1/million). Clinical and radiological differences between AQP4-antibody and MOG-antibody associated diseases have led to interest in the revisions of NMOSD definition and expanded stratification based on detection of a specific autoantibody biomarker. More population-based studies in different geographical regions and racial groups will be useful to further inform the prevalence and incidence of NMOSD and their antibody-specific subgroups. Accessibility to AQP4-antibody and MOG-antibody testing, which is limited in many centers, is a challenge to overcome. Environmental and genetic studies will be useful accompaniments to identify other potential pathogenetic factors and specific biomarkers in NMOSD.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Neuromyelitis Optica Spectrum Disorder and Its Prevalence and Incidence Worldwide

Hor¹,

et al. 2020

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“…Two of these patients showed gadolinium enhancement of the trigeminal nerve at the transitional zone, which contains an overlap of central and peripheral myelin features at the root level. In contrast, the remaining patient had an oculomotor nerve involvement at the root exit and the cisternal level that showed gadolinium enhancement that extended beyond the anticipated transitional zone between peripheral and central myelin . Vazquez Do Campo et al reported a patient with combined central and peripheral demyelination syndromes with elevated serum MOG IgG1 antibodies.…”

Section: Discussionmentioning

confidence: 99%

Linear pontine trigeminal root lesion in a patient with anti‐myelin oligodendrocyte glycoprotein antibody‐associated encephalitis

Fujimori

Nakashima

2020

Clinical & Exp Neuroim

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Background Anti‐myelin oligodendrocyte glycoprotein (MOG) antibody‐associated encephalitis is a new spectrum of disease entities that includes acute disseminated encephalomyelitis, brainstem encephalitis and cortical encephalitis. Recently, we encountered a case of anti‐MOG antibody‐associated encephalitis in which the patient presented with a linearly shaped lesion at the trigeminal root entry zone, which is one of the well‐known characteristic magnetic resonance imaging (MRI) findings in patients with multiple sclerosis. Here, we report this case, as several studies suggested that the reactivation of Herpes simplex viruses contribute to the formation of the linear pontine trigeminal root lesions in multiple sclerosis. Case presentation A 39‐year‐old woman was referred to our department because she developed numbness of the left side of her face. She had experienced convulsive seizures of unknown cause 2 years prior. Neurological examination showed left facial hypesthesia (ophthalmic and maxillary divisions). Brain MRI showed a linearly shaped T2/fluid‐attenuated inversion recovery hyperintense MRI lesion in the pons, which corresponded neuroanatomically with the intramedullary trigeminal root. A live cell‐based assay showed that the patient was positive for serum anti‐MOG antibodies. We diagnosed her with anti‐MOG antibody‐associated encephalitis. Two courses of high‐dose i.v. methylprednisolone were administered. Thereafter, the patient’s neurological symptoms and MRI findings improved. Conclusions A linear pontine trigeminal root lesion was observed in a patient with anti‐MOG antibody‐associated encephalitis. The association of herpesviruses requires more attention in the pathogenesis of anti‐MOG antibody‐associated encephalitis.

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“…MOG-IgG+ patients with clinical and neuroimaging characteristics of NMOSD are currently discussed as a different disease entity (17)(18)(19)(20)(21)(22)(23). Cortical encephalitis and seizures or cranial nerve involvement have also been reported in MOG-IgG+ patients (24)(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

Differences in Advanced Magnetic Resonance Imaging in MOG-IgG and AQP4-IgG Seropositive Neuromyelitis Optica Spectrum Disorders: A Comparative Study

et al. 2020

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Aims: To explore differences in advanced brain magnetic resonance imaging (MRI) characteristics between myelin oligodendrocyte (MOG) immunoglobulin (IgG) and aquaporin-4 (AQP4) IgG seropositive (+) neuromyelitis optica spectrum disorders (NMOSD). Methods: 33 AQP4-IgG and 18 MOG-IgG seropositive NMOSD patients and 61 healthy control (HC) subjects were included. All 112 participants were scanned with the same standardized MRI-protocol on a 3-Tesla MRI-scanner. Brain volume and diffusion tensor imaging (DTI) parameters were assessed. Results: MOG-IgG+ patients showed reduced parallel diffusivity within white matter tracts compared to HC whereas AQP4-IgG+ showed no significant brain parenchymal damage in DTI analysis. AQP4-IgG+ patients showed reduced whole brain volumes and reduced volumes of several deep gray matter structures compared to HC whereas MOG-IgG+ patients did not show reduced brain or deep gray matter volumes compared to HC. Conclusions: Microstructural brain parenchymal damage in MOG-IgG+ patients was more pronounced than in AQP4-IgG+ patients, compared with HC, whereas normalized brain volume reduction was more severe in AQP4-IgG+ patients. Longitudinal imaging studies are warranted to further investigate this trend in NMOSD. Our results suggest Schmidt et al. MRI Differences in NMOSD that MOG-IgG+ and AQP4-IgG+ NMOSD patients differ in cerebral MRI characteristics. Advanced MRI analysis did not help to differentiate between MOG-IgG+ and AQP4-IgG+ patients in our study.

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Cranial nerve involvement in patients with MOG antibody–associated disease

Cited by 61 publications

References 36 publications

Epidemiology of Neuromyelitis Optica Spectrum Disorder and Its Prevalence and Incidence Worldwide

Epidemiology of Neuromyelitis Optica Spectrum Disorder and Its Prevalence and Incidence Worldwide

Linear pontine trigeminal root lesion in a patient with anti‐myelin oligodendrocyte glycoprotein antibody‐associated encephalitis

Differences in Advanced Magnetic Resonance Imaging in MOG-IgG and AQP4-IgG Seropositive Neuromyelitis Optica Spectrum Disorders: A Comparative Study

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