MOGAD Presenting Atypically with Severely Elevated ICP and Meningoencephalitis: Severe Complicated Hospital Course Followed by Return to Near Baseline
Celeste Camargo1, Amanda Spinner2, Vikram Bhise3
1Neurology, Rutgers, 2Rutgers, 3Rutgers - Robert Wood Johnson Medical School
Objective:
Increase awareness that MOGAD can present with a phenotype of subacute CSF pleocytosis, seizures, alterned mental status, and malignant elevated ICP. Negative infectious work up in the setting of meningoencephalitis with or without elevated ICP pediatric population should prompt early evaluation for the presence of MOG antibodies.
Background:
Myelin oligodendrocyte glycoprotein associated disease (MOGAD) was first proposed as a distinct demyelinating disease in 2007. Its entire range of phenotypes is yet to be established.
Design/Methods:
Case report
Results:
We present an atypical case of a 15 year old boy with features identical to a viral meningoencephalitis with severely elevated ICP who was then diagnosed with MOGAD. After treatment with steroids, 7 rounds of PLEX and tocilizumab, he improved to near baseline. Literature review We reviewed other atypical MOGAD presentations for comparison.
Conclusions:
MOGAD can present with a phenotype of subacute CSF pleocytosis, seizures, alterned mental status, and malignant elevated ICP. Negative infectious work up in the setting of meningoencephalitis with or without elevated ICP pediatric population should prompt early evaluation for the presence of MOG antibodies.