MOG antibody‐positive cerebral cortical encephalitis: Two case reports and literature review

Abstract

Objective To investigate the clinical and MRI features of myelin oligodendrocyte glycoprotein (MOG) antibody‐positive cerebral cortical encephalitis. Methods To summarize the clinical manifestations, magnetic resonance imaging (MRI) features, and diagnosis and treatment of two children diagnosed with MOG antibody‐positive cortical encephalitis in our hospital, and to analyze all of the literature on MOG antibody‐positive associated cerebral cortical encephalitis published in the last 10 years. Results A total of 24 patients, 20 adults, and 4 children were included. The main symptoms of all observed patients were as follows: seizures 20/24 (83%), headache 18/24 (75%), fever 13/24 (54%), and increased cell number in cerebrospinal fluid 22/24 (92%). The main radiological sign was enhanced FLAIR signal in cortical 24/24 (100%), including enhanced fluid‐attenuated inversion recovery (FLAIR) signal in unilateral cortical 20/24 (83%). Conclusions The clinical manifestations of MOG antibody‐positive cerebral cortical encephalitis are complex and varied, and long‐term follow‐up is needed to clarify the prognosis and recurrence, providing reference for the clinical treatment.

Clinical characteristic of myelin oligodendrocyte glycoprotein antibody associated cortical encephalitis in adults and outcomes following glucocorticoid therapy

“…Taken together, these pieces of evidence, together with our results revealed the need for subsequent studies to determine whether anti-MOG antibodies are merely “concomitant antibodies” in cortical encephalitis. However, the response to the treatment revealed that MOG antibody-associated cortical encephalitis was sensitive to glucocorticoids ( Ogawa et al, 2017 ; Tian et al, 2021 ; Yao et al, 2022 ), which is consistent with the response to the treatment and clinical prognosis of MOGAD ( Ambrosius et al, 2020 ), but markedly different from anti NMDAR encephalitis. Titulaer and Dalmau et al found that nearly half of anti-NMDAR encephalitis patients did not obtain an effective relief of symptoms after receiving first-line immunotherapy (steroid hormone, IVIG and plasma exchange alone or in combination), and second-line immunotherapy (including rituximab andcyclophosphamide) was usually needed ( Dalmau et al, 2011 ; Titulaer et al, 2013 ).…”

Clinical analysis of adult MOG antibody-associated cortical encephalitis

“…Hence, some researchers also called it as MOG antibody-associated autoimmune encephalitis (AE) (Wegener-Panzer et al, 2020) or cortical encephalitis . Few cases of MOG antibody-associated cortical encephalitis have been reported (Ogawa et al, 2017, Tian et al, 2021, Ikeda et al, 2018, Fujimori et al, 2017, but understanding of this syndrome remains limited. Wang et al reported that 20.7% of anti-MOG patients had typical presentations of encephalitis, which was a far higher percentage than that of anti-aquaporin 4 (AQP4) patients (Wang et al, 2019).…”

Myelin Oligodendrocyte Glycoprotein Antibody Associated Cerebral Cortical Encephalitis: Case Reports and Review of Literature

“…We finally obtained 33 cases from 25 articles and combined with our two cases, a total of 35 cases were reviewed systematically ( Ogawa et al, 2017 ; Hamid et al, 2018 ; Ikeda et al, 2018 ; Budhram et al, 2019 , 2020 ; Haddad et al, 2019 ; Patterson et al, 2019 ; Fujimori et al, 2020b ; Hochmeister et al, 2020 ; Katsuse et al, 2020 ; Matoba et al, 2020 ; Otani et al, 2020 ; Russ et al, 2020 ; Takamatsu et al, 2020 ; Tao et al, 2020 ; Ahsan et al, 2021 ; Chang et al, 2021 ; Doig et al, 2021 ; Jain et al, 2021 ; Kim et al, 2021 ; Maniscalco et al, 2021 ; Nie et al, 2021 ; Stamenova et al, 2021 ; Tian et al, 2021 ; Wang et al, 2021 ; Table 1 ). The main demographic data, clinical characteristics, laboratory results, and imaging results are presented in Table 2 .…”