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289 MRI abnormalities in mog antibody disease
  1. Huda S1,
  2. Amal Al-Orainy2,
  3. Anita Saldanha1,
  4. Whittam D1,
  5. Christine Denby1,
  6. Lekha Pandit3,
  7. Bhojak M1,
  8. Jacob A1
  1. 1The Walton Centre NHS Foundation Trust
  2. 2University of Liverpool
  3. 3Nitte University, Mangalore, India


Aims To analyse the MRI abnormalities of myelin oligodendrocyte glycoprotein-antibody (MOG-Ab) associated demyelinating disease.

Methods Clinical records and 165 MRIs from 56 patients with MOG-Abs were reviewed.

Results The median age was 29(8–71) years and 52% percent were female. Common phenotypes included isolated optic neuritis (ON)=17, or transverse myelitis (TM)=16, ON+TM =12, and combinations of above groups with cerebral and/or brainstem involvement=11. Seventeen patients (30%) fulfilled NMOSD 2015 diagnostic criteria.

All patients had brain imaging and 89% (50/56) had spinal imaging. Common areas of MRI brain abnormality involved brainstem(32%), hemispheric white matter(29%), corticospinal tracts(21%), and U-fibres(20%). Dawson’s fingers were not detected in any patients.

Cord imaging showed longitudinally extensive myelitis in 69% (20/29) and atrophy in 4% (2/47). Optic nerve imaging was abnormal in 69% (18/26) of patients, with bilateral lesions in 33% and long lesions (orbital and/or canalicular) in 83%.

On serial MRI, radiological improvement was observed in 76% (22/29; median interval- 14 months) and importantly asymptomatic new lesions were absent in 13 untreated patients after a median of 16.5 months.

Conclusions Apart from optic nerve and spinal cord changes, brainstem and hemispheric white matter abnormalities are common in MOG-antibody disease. Irrespective of treatment, asymptomatic accrual of brain and/or spinal lesions is uncommon.

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