| Sammanfattning: | <h4>Importance</h4> <p>Antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) are being increasingly detected in patients with non-multiple sclerosis (MS) demyelination, some of whom manifest a neuromyelitis optica phenotype (NMO). Cortical involvement, encephalopathy and seizures are exceptionally rare in aquaporin4 antibody (AQP4-IgG) related NMO in Caucasians.</p> <h4>Objective:</h4> <p>To compare incidence of encephalopathy and or seizure like presentation among aquaporine 4 antibody positive (AQP4-IgG +ve) and myelin oligodendrocytes glycogen antibody positive (MOG-IgG1+ve) patients.</p> <h4>Design:</h4> <p>Having encountered one MOG-IgG positive patient with an encephalopathy and seizures, we retrospectively reviewed all our patients seropositive for MOG-IgG1 and the last 100 patients with AQP4-IgG disease (NMO spectrum disorder).</p> <h4>Settings:</h4> <p>All patients were seen in a tertiary neurological centre, The Walton centre NHS Foundation trust in Liverpool, United Kingdom.</p> <h4>Participants:</h4> <p>All patients who were seropositive for MOG-IgG1 and the last 100 patients who were AQP4-IgG postive seen in our centre</p> <h4>Results:</h4> <p>Five of the 34 patients with MOG-IgG1 had seizures 116 (14 .7%) compared to one AQP4-IgG patient (p<0.008, Fisher’s test). All five MOG-IgG1 patients had inflammatory cortical brain lesions associated with the seizures. In three cases the seizures occurred as part of the index event. In 4/5 cases, presentation was with an encephalopathy and seizures. All five patients developed relapsing disease. 4/5 MOG-IgG1 patients with seizures are on immunosuppressant and three continue on antiepileptic medication. In contrast, the only AQP4-IgG patient with seizures had a diagnosis of complex partial epilepsy preceding the onset of NMO by several years and did not experience any encephalitic illness, her MRI demonstrated no cortical, subcortical or basal ganglia involvement.</p> <h4>Conclusion and relevance:</h4> <p>Patients with antibodies to myelin oligodendrocytes glycoproteins (MOG-IgG1) associated disease were more likely to have seizures and encephalitis-like presentation compared to aquaporin 4 antibody (AQP4-IgG +ve) associated cases.</p>
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