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Background and Purpose: Myelin oligodendrocyte glycoprotein-antibody associated disease (MOGAD) is an increasingly recognized cause of demyelinating disease in children. The purpose of this study is to characterize the CNS imaging manifestations of pediatric MOGAD and identify clinical and imaging variables associated with relapse., Materials and Methods: We retrospectively identified children with serum antibody-positive MOGAD evaluated at our institution between 1997 and 2020. Clinical and demographic data were collected. MRIs of the brain, orbit, and spine at presentation and relapse were reviewed for location and pattern of abnormality., Results: Among 61 cases (34 girls), mean age at presentation was 7 years (IQR 4-11). At presentation, there was imaging involvement of the brain in 78.6% (44/56), optic pathway in 55.4% (31/56), and spine in 19.6% (11/56). Brain involvement was commonly in the frontal (70.5%, 31/44) and subcortical (75%, 33/44) white matter, with involvement of the thalamus and pons in 47.7% each (21/44). Optic neuritis (ON) was commonly bilateral (80.6%, 25/31) involving intraorbital segments (77.4%, 24/31). Spinal cord lesions were typically cervical (72.7%, 8/11) and multifocal (72.7%, 8/11).The imaging patterns were age-dependent; children ≤9 years more commonly demonstrated ADEM-like imaging pattern at presentation (39.4%, 13/33) and first relapse (8/23, 34.8%), while children >9 years more commonly had ON at presentation (34.8%, 8/23, P  = .001) and FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures at first relapse (5/18, 27.8%, P  = .008)., Conclusions: We describe the CNS imaging findings in pediatric MOGAD. The imaging pattern is age-dependent at presentation and first relapse. Younger age at presentation is associated with longer time to relapse., (© 2024 by American Journal of Neuroradiology.)

Background: Ovarian hyperstimulation syndrome (OHSS) is considered to be an iatrogenic complication of ovulation induction therapy. However, OHSS may rarely be associated with spontaneous ovulatory cycles, usually in multiple or molar gestations or hypothyroidism. Clinical manifestations vary and may be potentially fatal in severe cases., Case Report: A 28-year-old primigravid, with no history of an infertility treatment, presented with enlarged ovaries and ascite. The patient had minor abdominal discomfort, without other complains. Ultrasound evaluation showed enlarged cystic ovaries and mild ascites. Hormonal profile revealed increased estradiol levels, with normal TSH and hCG. The patient was managed expectantly with no complications., Discussion: Although spontaneous OHSS is a rare entity, it is important to consider it in cases of bilateral ovarian masses in pregnancy. Three different mechanisms responsible for the occurrence of spontaneous OHSS have been described. This syndrome is thought to be secondary to promiscuity of the FSH receptor for hCG and/or TSH. It may occur with normal or increased levels of hCG and/or TSH.