Contributions
Abstract: EP1305
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - MS Variants
Introduction: Antibodies to myelin oligodendrocyte glycoprotein (MOG) have been demonstrated in a subset of patients with Neuromyelitis Optica Spectrum Disorder (NMOSD) without the presence of aquaporin-4-IgG antibodies, as well as in patients with acute disseminated encephalomyelitis (ADEM), optic neuritis (ON), transverse myelitis (TM), brainstem syndrome and cerebral dysfunction without fulfilling criteria for NMOSD.
Objectives: To describe the clinical course, treatment and outcome in patients with MOG antibody-associated demyelination.
Methods: This is a retrospective case study. Demographic, clinical, cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) data were collected from the clinical records.
Results: Eleven patients with MOG-antibody associated demyelination were identified. The male/female ratio was 1.7. Mean age was 45.18 (range 22-71 years), while the mean disease duration was 6.72 (range 8 months-28 years). Three patients had an initial presentation of Longitudinally Extensive Transverse Myelitis (LETM) and one had TM. Three patients had bilateral ON and one had unilateral ON. There was one patient with a simultaneous LETM and unilateral ON. One of our patients had an ADEM-like initial presentation and one a cerebral-cortical dysfunction. MRI findings were compatible with the patient's clinical presentation, with or without additional asymptomatic brain lesions. Two of our patients had positive CSF oligoclonal bands. All cases were initially treated with intravenous steroids, while two patients with LETM required plasma exchange. Four out of five patients with TM had a very good outcome with Expanded Disability Status Scale (EDSS) score < 2. All ON cases had an excellent response to steroids. Six patients had only one episode, while five patients had a polyphasic course. Four out of five cases with a polyphasic course, had either clinical or/and radiological cerebral involvement at presentation and a worse outcome with moderate to severe disability. Additional immunosuppressive treatment has been added to our relapsing cases. Current EDSS scores ranges from 0-8 (mean value 2.54). Only four patients fulfilled diagnostic criteria for NMOSD.
Conclusions: MOG antibodies are associated with an increasing spectrum of clinical phenotypes that often do not fulfil criteria of NMOSD. Further large prospective studies are needed, to better characterise MOG-associated demyelination.
Disclosure: Athanasios Papathanasiou: nothing to disclose
Cris Constantinescu: nothing to disclose
Christopher Gilmore: nothing to disclose
Nikos Evangelou: nothing to disclos
Bruno Gran: nothing to disclose
Esmaeil Nikfekr: nothing to disclose
Radu Tanasescu: nothing to disclose
Abstract: EP1305
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - MS Variants
Introduction: Antibodies to myelin oligodendrocyte glycoprotein (MOG) have been demonstrated in a subset of patients with Neuromyelitis Optica Spectrum Disorder (NMOSD) without the presence of aquaporin-4-IgG antibodies, as well as in patients with acute disseminated encephalomyelitis (ADEM), optic neuritis (ON), transverse myelitis (TM), brainstem syndrome and cerebral dysfunction without fulfilling criteria for NMOSD.
Objectives: To describe the clinical course, treatment and outcome in patients with MOG antibody-associated demyelination.
Methods: This is a retrospective case study. Demographic, clinical, cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) data were collected from the clinical records.
Results: Eleven patients with MOG-antibody associated demyelination were identified. The male/female ratio was 1.7. Mean age was 45.18 (range 22-71 years), while the mean disease duration was 6.72 (range 8 months-28 years). Three patients had an initial presentation of Longitudinally Extensive Transverse Myelitis (LETM) and one had TM. Three patients had bilateral ON and one had unilateral ON. There was one patient with a simultaneous LETM and unilateral ON. One of our patients had an ADEM-like initial presentation and one a cerebral-cortical dysfunction. MRI findings were compatible with the patient's clinical presentation, with or without additional asymptomatic brain lesions. Two of our patients had positive CSF oligoclonal bands. All cases were initially treated with intravenous steroids, while two patients with LETM required plasma exchange. Four out of five patients with TM had a very good outcome with Expanded Disability Status Scale (EDSS) score < 2. All ON cases had an excellent response to steroids. Six patients had only one episode, while five patients had a polyphasic course. Four out of five cases with a polyphasic course, had either clinical or/and radiological cerebral involvement at presentation and a worse outcome with moderate to severe disability. Additional immunosuppressive treatment has been added to our relapsing cases. Current EDSS scores ranges from 0-8 (mean value 2.54). Only four patients fulfilled diagnostic criteria for NMOSD.
Conclusions: MOG antibodies are associated with an increasing spectrum of clinical phenotypes that often do not fulfil criteria of NMOSD. Further large prospective studies are needed, to better characterise MOG-associated demyelination.
Disclosure: Athanasios Papathanasiou: nothing to disclose
Cris Constantinescu: nothing to disclose
Christopher Gilmore: nothing to disclose
Nikos Evangelou: nothing to disclos
Bruno Gran: nothing to disclose
Esmaeil Nikfekr: nothing to disclose
Radu Tanasescu: nothing to disclose