Viral encephalitis followed by anti-NMDAR encephalitis with concomitant MOG antibody-positive central nervous system demyelination in a child

Excerpt

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis associated with immunoglobulin G (IgG) antibodies against the NMDAR GluN1 subunit. It is characterized by behavioral changes, movement disorder, seizures, and autonomic dysfunction [1]. Myelin oligodendrocyte glycoprotein (MOG) is a myelin protein expressed at the outermost surface of myelin sheaths in the central nervous system (CNS). Extensive research has reported the detection of MOG antibody in a wide clinical spectrum of CNS demyelinating diseases, including acute disseminated encephalomyelitis (ADEM), optic neuritis, myelitis, aquaporin-4 (AQP4)-seronegative neuromyelitis optica spectrum disorders (NMOSD), and encephalitis [2]. Anti-NMDAR encephalitis and MOG antibody-positive CNS demyelination can occur in the same patient simultaneously or sequentially [3]. …