| Abstract [eng] |
Myelin oligodendrocyte glycoprotein antibody-associated encephalitis is a rare autoimmune inflammatory demyelinating pathology of the central nervous system, belonging to the spectrum of myelin oligodendrocyte glycoprotein antibody-associated disease. For a long time, this condition was considered part of multiple sclerosis or neuromyelitis optica spectrum disorder, however, with the advancement of serological testing, myelin oligodendrocyte glycoprotein antibody-associated disease has been recognized as a distinct nosological entity with unique clinical, radiological, histopathological, and immunological features. The clinical spectrum of the disease includes optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, encephalitis, as well as brainstem and cerebellar involvement. The disease occurs across all age groups – approximately half of patients experience a monophasic course, while the remainder develop relapsing disease associated with long-term neurological deficits. The recognition and differentiation of myelin oligodendrocyte glycoprotein antibody-associated disease from other demyelinating disorders has been has been made easier by the International MOGAD Diagnostic Criteria proposed in 2023, which are based on clinical presentation, serological detection of MOG-IgG antibodies, and magnetic resonance imaging findings. Despite significant progress, many aspects of the disease remain insufficiently understood. Although an association with MOG-IgG antibodies has been established, the precise immunological mechanisms underlying central nervous system damage are still unclear. Furthermore, there is a lack of long-term prospective studies, clearly defined prognostic factors, and standardized treatment algorithms. Current therapeutic strategies are largely based on retrospective studies and clinical experience derived from the management of other demyelinating diseases. The clinical case presented in this study, together with a review of the latest scientific literature, illustrates real-world diagnostic challenges and contributes to earlier recognition and more effective patient management in clinical practice. |
