MOGAD following anti-NMDAR encephalitis: A case report

Abstract

Anti-N-methyl-D-aspartate receptor antibody and myelin oligodendrocyte glycoprotein antibody can coexist. Some patients have NMDAR encephalitis and MOG antibody disease successively. We report a rare case of MOGAD following anti-NMDAR encephalitis. Three years ago, a female of 44 years, our patient developed headache, mental disorder, and epilepsy. Cerebrospinal fluid was positive for NMDAR antibodies, and the patient’s symptoms improved after immunomodulatory treatment. Three months ago, the patient had a sudden loss of vision in the left eye. Orbital magnetic resonance imaging was supportive of left optic neuritis. Cerebrospinal fluid was positive for NMDAR and MOG antibodies. She was then diagnosed with MOGAD with anti-NMDAR encephalitis. In conclusion, when patients with anti-NMDAR encephalitis have demyelinating symptoms such as decreased vision, numbness or weakness of the limbs, it is necessary to consider whether they are combined with MOGAD.