A Case of Anti-Myelin Oligodendrocyte Glycoprotein Antibody-Associated Myelitis Presenting with Vertigo and Sensorineural Hearing Loss

We report a case of a 44-year-old man who presented with dizziness, left sensorineural hearing loss, leg numbness, and gait disturbance. Initial MRI of the head and spine and CSF examination revealed no abnormal findings. Neurotological examinations suggested a central pathology: Auditory Brainstem Response (ABR) showed a loss of waves II and subsequent waves, and Vestibular Evoked Myogenic Potentials (VEMPs) revealed bilateral latency delays (cVEMP and oVEMP), indicating decreased neural conduction velocity. The patient’s symptoms, including the hearing and lower limb deficits, responded well to steroid therapy, but relapsed upon steroid discontinuation. After a second relapse six months later, a repeat spinal MRI revealed myelitis, and Anti-Myelin Oligodendrocyte Glycoprotein (MOG) antibody was detected in the CSF, which led us to make a definitive diagnosis of Anti-MOG Antibody-Positive Myelitis.