Atypical Anti-MOG syndrome with aseptic meningoencephalitis and pseudotumor cerebri-like presentations.
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.
['Narayan|Ram N|RN|', 'Wang|Cynthia|C|', 'Sguigna|Peter|P|', 'Husari|Khalil|K|', 'Greenberg|Benjamin|B|']
D000293:Adolescent D000328:Adult D000906:Antibodies D005260:Female D006801:Humans D008297:Male D008590:Meningoencephalitis D063308:Myelin-Oligodendrocyte Glycoprotein D009902:Optic Neuritis D011559:Pseudotumor Cerebri
MOG Aseptic meningoencphalitis Myelin oligodendrocyte glycoprotein