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MOG antibody disease — SCE Neurology MCQ

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HardMSMOG antibody diseaseSCE Neurology

A 27-year-old man presented with optic neuritis with marked disc swelling after a preceding viral illness. On examination, visual recovery was good after steroids but relapse occurred on tapering. Initial investigations showed: MRI showed fluffy cortical-subcortical lesions; serum MOG-IgG was positive. What is the most likely diagnosis?

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Correct answer: D — MOG antibody-associated disease with recurrent steroid-responsive optic neuritis

Marked optic-disc swelling, good steroid responsiveness with relapse on tapering, fluffy cortical-subcortical lesions and positive serum MOG-IgG strongly support MOGAD. AQP4-NMOSD more often has poorer visual recovery and longitudinally extensive myelitis.

Reference: MOGAD practical recommendations for diagnosis and management: https://pubmed.ncbi.nlm.nih.gov/41167090/