Severe presentation of myelin oligodendrocyte glycoprotein antibody-associated disease: A case report

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory demyelinating disease of the central nervous system. Relapse may be moderate to severe with an Expanded Disability Status Scale (EDSS) above 4.0 in half of patients, albeit most experience good to excellent motor recovery. Herein, we present an atypically severe case of MOGAD with an unusual clinical course. Patient initially presented with diplopia, lower limb motor deficit and hypoesthesia which rapidly deteriorated into quadriplegia. Corticosteroid regimen did not initially translate to significant clinical improvement (EDSS=9.0). At the 1 year follow up, patient had regained some mobility although with marked sequela (EDSS=6.5). Although MOGAD is generally thought to be benign, it could also present with severe episodes.