What question did this study set out to answer?

To characterize the clinical features of adult patients with MOG antibody-associated disease presenting with seizures as the initial symptom.

February 27, 2026Frontiers in Neurology0 citationsOpen Access

Seizures as the initial manifestation: characterizing the adult phenotype of MOG antibody-associated disease

XCXuXin CaoHebei Medical University TWT. J. WangHebei Medical University PZPei ZhangHebei Medical University

Key Points

To characterize the clinical features of adult patients with MOG antibody-associated disease presenting with seizures as the initial symptom.
Retrospective analysis of clinical data from 7 patients with seizures as the initial symptom among 16 MOG antibody-positive patients
Clinical characteristics, cerebrospinal fluid analysis, cranial MRI, and EEG results were evaluated
Treatment involved corticosteroids, intravenous immunoglobulin, and antiepileptic drugs
All 7 patients presented with epileptic seizures; 3 also had fever and 4 had headaches
Seizure types included focal and generalized tonic-clonic seizures
Cerebrospinal fluid showed elevated pressure in 4 patients, with leukocyte count increased in 2
MRI revealed cortical lesions in 3 patients, while 4 showed no abnormalities
EEG showed focal slow waves in 5 patients; all achieved a favorable prognosis with one recurrence

Abstract

Objective Clinical Characteristics of Adult MOG Antibody-Associated Disease Presenting with Seizures as the Initial Symptom. Methods A retrospective analysis was conducted on the clinical data of 7 patients who presented with epileptic seizures as the initial symptom among 16 adult MOG antibody-positive patients admitted to the Department of Neurology at Xingtai People’s Hospital in Hebei Province from August 2020 to March 2025. Results In this study, the age of onset of the 7 patients ranged from 18 to 75 years. All patients presented with epileptic seizures as the initial symptom, with 3 cases accompanied by fever and 4 cases by headache. Among the 7 patients, seizure types included focal seizures and generalized tonic–clonic seizures. Cerebrospinal fluid (CSF) pressure was elevated in 4 cases, while leukocyte count was increased in 2 cases. Cranial magnetic resonance imaging (MRI) revealed cortical lesions in 3 patients without significant meningeal enhancement, and 4 cases showed no abnormal findings on MRI. Electroencephalography (EEG) revealed focal slow waves in 5 cases, while 2 cases showed normal findings. All 7 patients were treated with hormones, 2 received intravenous human immunoglobulin, and 5 were administered antiepileptic drugs. All 7 patients achieved favorable prognosis, with one case of recurrence. Conclusion In adult MOG antibody-positive patients presenting with epileptic seizures as the initial symptom, the disease can occur at any age without a clear sex predominance. These patients may present with non-specific clinical features such as fever, headache, and abnormalities in cerebrospinal fluid and electroencephalography. Some patients may exhibit isolated epileptic seizures. Cranial magnetic resonance imaging often reveals cortical signal abnormalities. For adult patients presenting with seizures as the first symptom, early MOG antibody testing is essential for a definitive diagnosis. Prompt initiation of corticosteroid or intravenous immunoglobulin therapy can effectively control disease progression.

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