Abstract
Background
Anti-myelin oligodendrocyte glycoprotein (MOG) antibody can be detected not only in
acute disseminated encephalomyelitis or optic neuritis but also in limbic or cortical
encephalitis. However, no previous reports have demonstrated a relapsing case of these
two types of encephalitis.
Case report
An 11-year-old girl presented with fever, headache, abnormal behavior, focal impaired
awareness seizures (FIAS) on the left side, and MRI hyperintensities in the bilateral
amygdala, hippocampus, and right posterior temporal cortex. The symptoms were alleviated
with two courses of intravenous methylprednisolone (IVMP) and one course of immunoglobulin.
At 16 years of age, the patient returned with left-sided headache and MRI hyperintensities
in the left temporal, parietal, and insular cortices, which improved after 3 courses
of IVMP. Oral prednisolone (PSL) was tapered over 6 months, when FIAS reappeared on
the right side of the body. MRI showed recurrence in the same regions as in the second
episode. She received 3 courses of IVMP, followed by gradually tapered PSL without
relapse for 1.5 year. Anti-MOG antibodies were positive in both serum and the cerebrospinal
fluid prior to treatment in all three episodes.
Conclusion
Our results revealed that anti-MOG antibody-related bilateral limbic and unilateral
cortical encephalitis can manifest with a variety of phenotypes over time in the same
patient.
Keywords
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Article info
Publication history
Published online: November 18, 2021
Accepted:
October 26,
2021
Received in revised form:
October 11,
2021
Received:
June 1,
2021
Identification
Copyright
© 2021 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
