Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan.
Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan.
Mult Scler Relat Disord. 2020 Jun;41:102040. doi: 10.1016/j.msard.2020.102040. Epub 2020 Mar 5.
Autoantibody against myelin oligodendrocyte glycoprotein (MOG) has been reported in a range of demyelinating neurological entities. Recent studies demonstrate a wider spectrum of MOG-IgG-associated disorders with the discovery of MOG-IgG-positive brainstem encephalitis, cortical encephalitis, and cranial nerve involvement with concurrent central nervous system involvement. We present a MOG-IgG-positive pediatric patient diagnosed with isolated oculomotor neuritis without concurrent central nervous system neuroimaging lesions, in the absence of a demyelinating event. Brain MRI shows swelling and gadolinium enhancement of the left oculomotor nerve at the cisternal segment. This is the first report to demonstrate MOG-IgG seropositivity in isolated cranial nerve lesions. This case may expand the clinical phenotype of MOG-IgG-associated diseases, and clinicians should not hesitate to test for MOG-IgG in cases with neuroimaging features of cranial neuritis alone.
抗髓鞘少突胶质细胞糖蛋白（MOG）自身抗体已在一系列脱髓鞘神经疾病中报道。最近的研究显示，随着脑桥脑炎、皮质脑炎和伴发中枢神经系统受累的颅神经受累等一系列 MOG-IgG 相关疾病的发现，MOG-IgG 的谱更宽。我们报告了一例 MOG-IgG 阳性儿科患者，该患者诊断为孤立性动眼神经神经炎，无伴发中枢神经系统神经影像学病变，无脱髓鞘事件。脑 MRI 显示左侧动眼神经池段肿胀并钆增强。这是首例报告显示 MOG-IgG 血清阳性的孤立性颅神经病变。该病例可能扩展了 MOG-IgG 相关疾病的临床表型，临床医生不应犹豫在仅存在颅神经炎神经影像学特征的情况下检测 MOG-IgG。
