Authors
Ajay Nathan, Bharat Rajkumar, M Kasiviswanathan, Anmol Sharma
Published in
Neurology India. Volume 74. Issue 4. Pages 675-677. Jul 01, 2026. Epub Jul 21, 2026.
Abstract
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a rare autoimmune demyelinating disorder of the central nervous system that can present with varied neurological symptoms. While commonly mistaken for multiple sclerosis or neuromyelitis optica spectrum disorders, MOGAD can also mimic cerebrovascular events, posing a diagnostic challenge. We report a case of a 30-year-old male who initially presented with acute-onset left-sided hemiplegia and right facial palsy, raising suspicion of an ischemic stroke. Despite thrombolysis, his recurrent neurological symptoms, including dysarthria and cerebellar ataxia, prompted further evaluation. Neuroimaging revealed hyperintense lesions in the right hemi-pons and bilateral middle cerebellar peduncles, raising the possibility of a demyelinating disorder. MOG-IgG seropositivity confirmed the diagnosis of MOG encephalitis. The patient responded well to pulse corticosteroid therapy, followed by maintenance immunosuppression with mycophenolate mofetil, and remained asymptomatic on follow-up. This case underscores the importance of considering autoimmune demyelinating disorders in young patients with recurrent neurological deficits and clinico-radiological dissociation. Early recognition and appropriate immunotherapy can prevent unnecessary thrombolysis and improve patient outcomes. Clinicians should maintain a high index of suspicion for MOGAD as a potential stroke mimic in atypical presentations.
PMID:
42478405
Bibliographic data and abstract were imported from PubMed on 21 Jul 2026.
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