Challenging Diagnosis and Management of MOG Antibody Disease (MOGAD) in a Seven-Year-Old Girl with Acute Disseminated Encephalomyelitis (ADEM): A Case Report and Literature Revie

Glorie Chubaka Magala; Cédric Valéry Kadjo; Abel Christian Tanoh; Fiacre Delors OFFOUMOU; Muriel Amon-Tanoh; Désirée Arlette Aka; N’da Dihoiba Kouassi; Mavouloh Kourouma; Constance Yapo-Ehounoud; Paulette Yapo; Mariam Doumbia-Ouattara; Evelyne Aka- Anghui Diarra; Berthe  Assi

Authors

Glorie Chubaka Magala Neurology, Cocody University Hospital https://orcid.org/0000-0001-8092-071X
Cédric Valéry Kadjo Department of Neurology, Cocody University Hospital, Abidjan, Ivory Coast
Abel Christian Tanoh Department of Neurology, Cocody University Hospital, Abidjan, Ivory Coast https://orcid.org/0009-0009-0763-6961
Fiacre Delors OFFOUMOU Department of Neurology, Cocody University Hospital, Abidjan, Ivory Coast https://orcid.org/0009-0001-8703-8321
Muriel Amon-Tanoh https://orcid.org/0000-0002-4480-3580
Désirée Arlette Aka https://orcid.org/0009-0001-1665-2500
N’da Dihoiba Kouassi Physiology Department, Felix Houphouet-Boigny University, Abidjan, Ivory Coast
Mavouloh Kourouma Department of Neurology, Cocody University Hospital, Abidjan, Ivory Coast https://orcid.org/0000-0002-2762-8792
Constance Yapo-Ehounoud Department of Neurology, Cocody University Hospital, Abidjan, Ivory Coast https://orcid.org/0000-0002-9001-1381
Paulette Yapo Radiology Department, Felix Houphouet-Boigny University, Abidjan, Ivory Coast
Mariam Doumbia-Ouattara https://orcid.org/0009-0009-4202-4055
Evelyne Aka- Anghui Diarra Department of Neurology, Cocody University Hospital, Abidjan, Ivory Coast
Berthe Assi Department of Neurology, Cocody University Hospital, Abidjan, Ivory Coast https://orcid.org/0000-0002-0201-9405

Keywords:

Acute disseminated encephalomyelitis (ADEM), Myelin oligodendrocyte glycoprotein antibody disease (MOGAD), case report, child, West Africa

Abstract

Background: Diseases associated with anti-MOG antibodies (MOGAD) are rare inflammatory conditions that have recently been recognised for their distinct clinical characteristics. These disorders predominantly affect children, with acute disseminated encephalomyelitis (ADEM) being the most prevalent manifestation. There is a lack of comprehensive data on this pathology in Africa. This study is the first documented case of MOGAD in West Africa. Case Presentation: A 7-year-old girl was admitted to the neurology unit with fluctuating motor impairment in all limbs lasting for 4 weeks. Neurological examination revealed spastic tetraparesis, along with extrapyramidal and cerebellar syndromes. 48 hours after admission, she presented with status epilepticus, with an EDSS score of 9.0. After neuroimaging and biological tests, the diagnosis of MOG antibody-associated disease (MOGAD) was confirmed. The patient's condition improved with corticosteroid treatment. However, anti-MOG antibodies remained positive after six months, leading to the decision to initiate immunosuppressive therapy to address the potential for relapse. Conclusion: MOGAD presents a considerable diagnostic challenge in tropical regions, largely due to the limited availability of magnetic resonance imaging and specific serological testing, leading to delays and inaccuracies in diagnosis.

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Challenging Diagnosis and Management of MOG Antibody Disease (MOGAD) in a Seven-Year-Old Girl with Acute Disseminated Encephalomyelitis (ADEM): A Case Report and Literature Revie

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