PMID- 36688157
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230201
IS  - 1663-4365 (Print)
IS  - 1663-4365 (Electronic)
IS  - 1663-4365 (Linking)
VI  - 14
DP  - 2022
TI  - Clinical characteristic of myelin oligodendrocyte glycoprotein antibody 
      associated cortical encephalitis in adults and outcomes following glucocorticoid 
      therapy.
PG  - 1076361
LID - 10.3389/fnagi.2022.1076361 [doi]
LID - 1076361
AB  - OBJECTIVE: To describe the clinical and radiological features, as well as 
      outcomes following glucocorticoid therapy and recurrence in adults suffering from 
      cortical encephalitis associated with myelin oligodendrocyte glycoprotein (MOG) 
      antibody. METHODS: The clinical information of nine adult patients suffering from 
      cortical encephalitis associated with MOG antibody admitted to the Affiliated 
      Brain Hospital of Nanjing Medical University from 2020 to 2022 was systematically 
      reviewed. The clinical symptoms, laboratory data, imaging results, outcomes 
      following glucocorticoid therapy and recurrence were evaluated. RESULT: A total 
      of 9 patients positive for MOG antibody and suffering from cortical encephalitis 
      were included in our study (55.6% men, median age 29 years, 15-57 years). The 
      most common clinical symptoms included headache (77.8%), fever (66.7%), and 
      generalized seizures (55.6%). Some patients also experienced limb shaking 
      (22.2%), leg numbness (22.2%), transient motor aphasia (11.1%), and vision loss 
      (11.1%). The main features of cerebrospinal fluid () examination were increased 
      intracranial pressure, pleocytosis, and elevated cerebrospinal fluid (CSF) 
      protein. In addition, N-methyl-D-aspartate receptor (NMDAR) and MOG antibodies 
      were found in the CSF of 3 patients, and NMDAR, MOG, and glial fibrillary acidic 
      protein antibodies were found in the CSF of 1 patient. All patients were 
      subjected to magnetic resonance imaging (MRI) and the images of eight of them 
      showed T2 and/flair image hyperintense lesions, three showed meningeal or lesion 
      enhancement and four showed white matter lesions, which were mostly located in 
      the midline structures (75%). All patients received glucocorticoid therapy in the 
      acute phase and in remission, and eight of them received an intravenous high dose 
      of methylprednisolone, including one patient who received a simultaneous 
      immunoglobulin therapy. One patient was treated with low-dose prednisolone 
      tablets. Seven (77.8%) patients were wholly recovered at discharge, and 2 (22.2%) 
      patients were left with slight symptoms. During the median 9-month follow-up 
      (range: 2-36 months), 2 (22.2%) patients developed recurrence. CONCLUSION: The 
      clinical manifestations of adult MOG antibody-associated cortical encephalitis 
      were significantly different from those of the typical MOG antibody-associated 
      disease (MOGAD). Patients in the acute phase of the disease were prone to show 
      signs similar to central nervous system infection, requiring clinicians to have 
      the ability to recognize the disease to avoid misdiagnosis. In addition, seizures 
      were common in MOG antibody-related encephalitis, and the type of seizures was 
      age-related. Brain MRI results showed that the distribution of cerebral cortex 
      lesions was closely related to the classification of cortical encephalitis. Based 
      on the patient's response to the treatment, glucocorticoid therapy was effective 
      against MOG antibody-associated cortical encephalitis, which is consistent with 
      the treatment response and clinical prognosis of MOGAD. Therefore, our opinion 
      was that MOG antibody might be the "responsible antibody" in MOG 
      antibody-associated cortical encephalitis, although further studies are needed to 
      confirm this hypothesis.
CI  - Copyright (c) 2023 Wu, Zhou, Ci, Lin, Zhang and Lu.
FAU - Wu, Yuqing
AU  - Wu Y
AD  - Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Zhou, Hao
AU  - Zhou H
AD  - Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Ci, Xiaojiao
AU  - Ci X
AD  - Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Lin, Liuyu
AU  - Lin L
AD  - Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Zhang, Da
AU  - Zhang D
AD  - Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Lu, Jie
AU  - Lu J
AD  - Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical 
      University, Nanjing, China.
LA  - eng
PT  - Journal Article
DEP - 20230104
PL  - Switzerland
TA  - Front Aging Neurosci
JT  - Frontiers in aging neuroscience
JID - 101525824
PMC - PMC9846213
OTO - NOTNLM
OT  - MOG
OT  - MRI
OT  - clinical feature
OT  - cortical encephalitis
OT  - glucocorticoids therapy
COIS- The authors declare that the study was conducted in the absence of any commercial 
      or financial relationships that could be construed as a potential conflict of 
      interest.
EDAT- 2023/01/24 06:00
MHDA- 2023/01/24 06:01
PMCR- 2022/01/01
CRDT- 2023/01/23 05:12
PHST- 2022/10/21 00:00 [received]
PHST- 2022/12/07 00:00 [accepted]
PHST- 2023/01/23 05:12 [entrez]
PHST- 2023/01/24 06:00 [pubmed]
PHST- 2023/01/24 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fnagi.2022.1076361 [doi]
PST - epublish
SO  - Front Aging Neurosci. 2023 Jan 4;14:1076361. doi: 10.3389/fnagi.2022.1076361. 
      eCollection 2022.