Diagnosis of Neuromyelitis Optica Spectrum Disorder (NMOSD) and MOG Antibody-Associated Disease (MOGAD).

Aquaporin-4 antibody-seropositive neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD; also termed MOG encephalomyelitis) are autoimmune diseases of the central nervous system. The typical initial manifestations in adult patients are optic neuritis and myelitis. Patients often present with additional involvement of the brain and brainstem, more so in the later stages of the disease. While NMOSD commonly follows a relapsing course, MOGAD can sometimes be monophasic. Differential diagnosis is challenging and relies particularly on radiological and serological findings. It is very important to distinguish these rare diseases from the more common neuroinflammatory disease, multiple sclerosis (MS), since treatment and long-term prognoses for NMOSD, MOGAD and MS differ greatly. The diversity of the symptoms and the extent of the diagnostic work-up necessitate close collaboration between ophthalmology, neurology, and radiology. This article provides an overview of the typical MRI findings and serological antibody diagnostics for NMOSD and MOGAD, supplemented with two exemplary case reports from clinical practice.
Competing Interests: Friedemann Paul: Vortragshonorar/Reisekosten von Alexion, Guthy Jackson Charitable Foundation, Bayer, Biogen, Merck Serono, Sanofi Genzyme, Novartis, Viela Bio, Roche, UCB, Mitsubishi Tanabe, Celgene (nicht im Zusammenhang mit diesem Artikel); Forschungsgelder von Alexion, Bundesministerium für Bildung und Forschung, Deutsche Forschungsgemeinschaft, Einstein Foundation, Guthy Jackson Charitable Foundation, EU FP7 Framework Program, Biogen, Genzyme, Merck Serono, Novartis, Bayer, Roche, Parexel, Almirall (nicht im Zusammenhang mit diesem Artikel); akademischer Editor für PLoS ONE; Associate Editor für Neurology Neuroimmunology & Neuroinflammation; wissenschaftliche Konsultation for SanofiGenzyme, Biogen Idec, MedImmune, Shire, und Alexion; wissenschaftlicher Beirat für Celgene, Roche, UCB, Merck. Claudia Chien; Vortragshonorar von Bayer und Forschungsgelder von Novartis (nicht im Zusammenhang mit diesem Artikel)./Friedemann Paul: Speaker fees/travel costs from Alexion, the Guthy Jackson Charitable Foundation, Bayer, Biogen, Merck Serono, Sanofi Genzyme, Novartis, Viela Bio, Roche, UCB, Mitsubishi Tanabe, and Celgene (not related to this article); research funding from Alexion, the Federal Ministry of Education and Research, the German Research Foundation, the Einstein Foundation, the Guthy Jackson Charitable Foundation, the EU FP7 Framework Program, Biogen, Genzyme, Merck Serono, Novartis, Bayer, Roche, Parexel, and Almirall (not related to this article); academic editor for PLoS ONE; associate editor for Neurology Neuroimmunology & Neuroinflammation; academic consultant for SanofiGenzyme, Biogen Idec, MedImmune, Shire, and Alexion; member of scientific advisory board for Celgene, Roche, UCB, and Merck. Claudia Chien; speaker fees from Bayer and research funding from Novartis (not related to this article).
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