Clinical and Radiological Features of Adult Onset Bilateral Medial Frontal Cerebral Cortical Encephalitis With Anti-myelin Oligodendrocyte Glycoprotein Antibody

• Published in: Frontiers in neurology Vol. 11; p. 600169
• Main Authors: Fujimori, Juichi, Nakamura, Masashi, Yagihashi, Takahito, Nakashima, Ichiro
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 16.12.2020
• Subjects: anterior cerebral artery; bilateral medial frontal lobe; cerebral cortical encephalitis; MRI; myelin oligodendrocyte glycoprotein; Neurology; cerebral cortical encephalitis; myelin oligodendrocyte glycoprotein; MRI; anterior cerebral artery; bilateral medial frontal lobe
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2020.600169

To clarify the clinical and radiological features of adult onset anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated bilateral medial frontal cerebral cortical encephalitis (BFCCE). We systematically reviewed the literature for patients with anti-MOG antibody-associated BFCCE. Patients who were also positive for other encephalitis-related autoantibodies were excluded from the study. The frequency of several characteristic neurological symptoms and lesion distributions were analyzed. We identified six patients with anti-MOG antibody-associated BFCCE. Among them, 6/6 had headache, 4/6 had fever, 3/6 had seizure, 2/6 had paraparesis, 2/6 had lethargy, and 2/6 had memory disturbance. CSF pleocytosis was observed in 5/6 patients, while CSF myelin basic protein was not elevated in any of the six patients. On brain MRI, 6/6 had bilateral medial frontal cortical lesions, 3/6 had corpus callosum lesions, and 3/6 had leptomeningeal enhancements. Most of the lesions were distributed in the territory of the anterior cerebral artery (ACA). Our results indicate that anti-MOG antibody-associated BFCCE presents with characteristic clinical symptoms and MRI findings, which might reflect lesion formation in the ACA territory.