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The following is a summary of “Cerebral cortical encephalitis in adults with myelin oligodendrocyte glycoprotein antibody-associated disease: A national case series,” published in the November 2024 issue of Neurology by Pace et al.    

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a recently recognized condition, frequently presenting as optic neuritis (ON) or longitudinally extensive transverse myelitis (LETM). Cerebral cortical encephalitis (CCE) is a rare manifestation in adults.  

Researchers conducted a retrospective study to describe clinical, laboratory, and treatment characteristics of CCE in adults with MOGAD.  

They identified adult patients with CCE and positive MOG antibodies from a large, specialized service, collecting demographic, clinical, and laboratory data. Clinical presentations, magnetic resonance imaging (MRI) findings, treatment response, and relapse risk were analyzed.  

The results showed that 8 patients met the criteria for CCE with MOG antibodies. All patients experienced seizures, with 50% (4 of 8) having focal onset seizures, encephalopathy was noted in 2 patients, while 6 had focal neurological deficits. Fluid-attenuated inversion recovery hyperintensities were observed in all cases, cerebral swelling in 5 of 8, 62.5%, and leptomeningeal enhancement in 2 of 8, 25%. Cerebrospinal fluid (CSF) findings included pleocytosis (5 of 7, 71.4%), elevated protein (2 of 7, 28.6%), and unique oligoclonal bands (OCBs) (1 of 7, 14.3%). The median time to seizure control was 1.25 months, and imaging abnormalities were resolved in all cases. Relapse occurred in 4 patients (50%) with a median of 6.4 months.  

They concluded that CCE in adults with MOGAD shared features like CSF findings, steroid responsiveness, and relapse risks with other MOGAD manifestations, aiding treatment and counseling.  

Source: onlinelibrary.wiley.com/doi/full/10.1111/ene.16550