The lesions were characterized by an unclear demarcation, eccentric axial location, and vague enhancement. There was mild swelling of the conus medullaris ( Figures 2A–C). Spinal magnetic resonance imaging (MRI) with contrast were obtained, revealing multiple T1-isointense and T2-hyperintense patchy lesions along the cervical, thoracic, lumbar segments, each extending over one to two vertebral segments. Routine workup including complete blood count, basic metabolic panel, and serum autoimmune panel were normal. On examination, the patient exhibited pain and temperature sensory loss, mild weakness bilaterally (Medical Research Council: 4/5 in right leg 4+/5 in left leg 4+/5 in left upper extremity), with an exaggerated deep tendon reflexes and positive Babinski signs bilaterally. Given the potential overlap of some clinical phenotypes in patients with MS and those with MOGAD, we recommend MOG antibody testing in all patients with recurrent short-segment myelitis, conus medullaris involvement, and those who demonstrated steroid dependence.Ī 25-year-old female presented with a 2-month history of progressive ascending paresthesia with incomplete bladder emptying. This case, along with previous reports, highlights an increasingly recognized subgroup in MOGAD with initial clinical phenotypes suggestive of MS, but later showing a disease course and therapeutic response compatible with MOGAD. Herein, we present a case with recurrent episodes of short-segment myelitis typical for multiple sclerosis, but later diagnosed as MOGAD by MOG antibody seropositivity. Being wary of this entity is critical to ensure appropriate therapy. However, in a proportion of patients, there may be an overlap in some of the clinical and radiological manifestations between MOGAD and multiple sclerosis (MS). Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) covers a wide spectrum of manifestations and is defined by the presence of MOG seropositivity. 3Department of Neurology, Fourth Affiliated Hospital School of Medicine Zhejiang University, Yiwu, China.2Department of Neurology, Second Affiliated Hospital School of Medicine Zhejiang University, Hangzhou, China.1Department of Neurology, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, China.Yang Zheng 1† Meng-Ting Cai 2† Er-Chuang Li 2 Wei Fang 3 Chun-Hong Shen 2 Yin-Xi Zhang 2*
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