Challenging diagnosis and management of MOG Antibody Disease (MOGAD) in a seven-year-old girl with acute disseminated encephalomyelitis (ADEM): a case report and literature review

Background: Diseases associated with anti-MOG antibodies (MOGAD) are rare inflammatory conditions that have recently been recognised for their distinct clinical characteristics. These disorders predominantly affect children, with acute disseminated encephalomyelitis (ADEM) being the most prevalent manifestation. There is a lack of comprehensive data on this pathology in Africa. This study is the first documented case of MOGAD in West Africa. Case Presentation: A 7-year-old girl was admitted to the neurology unit with fluctuating motor impairment in all limbs lasting for 4 weeks. Neurological examination revealed spastic tetraparesis, along with extrapyramidal and cerebellar syndromes. 48 hours after admission, she presented with status epilepticus, with an EDSS score of 9.0. After neuroimaging and biological tests, the diagnosis of MOG antibody-associated disease (MOGAD) was confirmed. The patient's condition improved with corticosteroid treatment. However, anti-MOG antibodies remained positive after six months, leading to the decision to initiate immunosuppressive therapy to address the potential for relapse. Conclusion: MOGAD presents a considerable diagnostic challenge in tropical regions, largely due to the limited availability of magnetic resonance imaging and specific serological testing, leading to delays and inaccuracies in diagnosis.