Sentinel seizure heralding Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease

Background Isolated seizure as a manifestation of myelin oligodendrocyte antibody-associated disease (MOGAD) has rarely been reported previously. Case presentation A 16-year-old-male presented with single episode of left focal onset motor seizure with secondary generalization and impaired awareness,...

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Published inThe Egyptian Journal of Neurology, Psychiatry and Neurosurgery Vol. 59; no. 1; pp. 31 - 4
Main Authors Das, Shambaditya, Pandit, Alak, Ray, Biman Kanti, Dubey, Souvik
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 09.03.2023
Springer Nature B.V
SpringerOpen
Subjects
Antibodies
Case Report
Convulsions & seizures
Medical imaging
Medicine
Medicine & Public Health
MOG
Myelin oligodendrocyte glycoprotein antibody
Neuroimaging
Neurology
Neurosurgery
Presenting manifestation
Primary CNS demyelination
Psychiatry
Seizure
Presenting manifestation
Myelin oligodendrocyte glycoprotein antibody
Seizure
MOG
Primary CNS demyelination
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Summary:Background Isolated seizure as a manifestation of myelin oligodendrocyte antibody-associated disease (MOGAD) has rarely been reported previously. Case presentation A 16-year-old-male presented with single episode of left focal onset motor seizure with secondary generalization and impaired awareness, without any other focal neurological deficits. There was a history of right focal onset motor seizure with secondary generalized tonic–clonic seizure and impaired awareness 4 years ago. Neurological examination showed bilateral gaze evoked nystagmus. Brain imaging revealed bilateral superficial and deep white matter lesions including the corpus callosum. Anti-MOG antibody was positive. The patient received steroids and Rituximab therapy without any further recurrence of seizure or any neuro-deficits and gradual improvement in lesion burden in brain imaging. Conclusions This case of an adolescent boy with sole manifestation of episodes of focal seizures 4 years apart, finally diagnosed to be a case of MOGAD, not only boosts the evidence of establishing the possibility of MOG antibody-associated autoimmune epilepsy but also reinforces the importance of unexplained seizure as a clinical phenotype in MOGAD.
ISSN:1110-1083
1687-8329
DOI:10.1186/s41983-023-00632-8