Health Library

Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD)

What Causes MOGAD?

Doctors and scientists don’t know the exact cause of MOGAD. They believe many factors contribute to the disease. What triggers the immune system to develop MOGAD is unique for every person.

MOGAD Symptoms

Symptoms can be different from child to child. They depend on where damage or inflammation of the myelin sheath occurs.

Common symptoms for MOGAD in children include:

• Eye problems, such as double vision, pain when moving the eyes and vision loss
• Difficulty processing information, organizing, planning and decision-making
• Weakness, tingling and numbness
• Problems with balance and coordination
• Tremors (shaking)
• Muscle stiffness and spasms, which can be painful
• Problems with bowel and bladder control
• Slurred speech

Other symptoms of MOGAD include:

• Trouble with memory and paying attention
• Seizures
• Fatigue

MOGAD Diagnosis

A neurologist is a doctor who specializes in conditions that affect the nerves. The doctor will ask about symptoms and do a neurologic exam. The doctor tests vision, hearing, sensation (feeling), strength and swallowing. Coordination, balance and reflexes also are tested. Blood tests may help rule out other reasons for symptoms. They can be used to determine if the antibody is present.

To confirm that a child has MOGAD, doctors use imaging tools. These create pictures of the brain, spinal cord and optic nerve. The main tests are:

• Magnetic resonance imaging (MRI). This uses a large magnet and radio waves to find and make pictures of inflamed areas.
• Spinal tap. The doctor will remove a sample of fluid surrounding the brain and spinal cord. The lab tests the fluid for signs of MOGAD and rules out infections or other diseases.
• Blood work. This rules out other infectious and inflammatory diseases that may have similar symptoms, and can test for the MOG antibody.

MOGAD Treatment

Three categories of MOGAD treatment include:

• Treatment of active inflammation. Steroids often are given to reduce inflammation from an active flare-up. During severe relapses, plasma (liquid part of the blood) exchange is used. This treatment removes antibodies (part of the body’s defense system) from the blood that may be attacking the myelin and causing symptoms. IVIG may also be used. This is an infusion of immunoglobulins (antibodies) that helps prevent the immune system from reacting to the normal tissue.
• Prevention of further relapses. Medications called immunotherapies or immunosuppressants may be used to prevent future relapses. These are not always needed. Options to help prevent relapses include medications by mouth and infusions.
• Treatment of symptoms related to MOGAD. Medications used to treat symptoms vary depending on symptoms caused by MOGAD relapses. These medications may be used during active inflammation or may be needed long term. Psychologists and psychiatrists will treat mood and cognitive symptoms. Occupational, speech and physical therapies are used to treat physical symptoms.

Some children with MOGAD stay on medication to prevent further relapses. Doctors will watch closely for new symptoms. Repeated brain MRIs may also be recommended.

MOGAD Prognosis

Some children may only have one MOG attack and recover well with acute therapy. Some may have residual symptoms after an attack. The risk of having another MOG attack after a first event is around 40-50%. With treatment and prevention of relapses, most children do not develop significant disability from MOGAD.

Managing flare-ups is important to maintain the best possible health, function and movement. Typically, children who have MOGAD have a good recovery and flare-ups are generally rare but can occur. Sometimes flare-ups may cause lasting damage to nerves. A child may not get back certain movements or functions. Alerting your doctor to any concerns around flare-ups or new symptoms is important to help ensure the right treatment is started, if needed.