Ogawa et al1 described a unilateral encephalitis with cortical T2 fluid-attenuated inversion recovery (FLAIR) hyperintensity, seizures, and myelin oligodendrocyte glycoprotein (MOG) immunoglobulin G (IgG) positivity. A literature review characterized unilateral cortical FLAIR–hyperintense lesions in anti-MOG–associated encephalitis with seizures (FLAMES) as a distinct clinicoradiographic syndrome that frequently presents with headache, fever, seizures, and/or cortical symptoms.2 A subset of these patients had unilateral leptomeningeal enhancement in addition to cortical T2 FLAIR hyperintensity,2 so we searched the Mayo Clinic MOG IgG–positive patient database looking for cases of unilateral meningeal and/or cortical signal abnormality on magnetic resonance imaging (MRI). Through this search, we identified 2 patients with isolated MOG IgG positivity and unilateral leptomeningeal enhancement in the absence of significant cortical T2-FLAIR hyperintensity, further expanding the neuroimaging spectrum of MOG IgG–associated disease (MOGAD).
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Budhram A, Kunchok AC, Flanagan EP. Unilateral Leptomeningeal Enhancement in Myelin Oligodendrocyte Glycoprotein Immunoglobulin G–Associated Disease. JAMA Neurol. 2020;77(5):648–649. doi:10.1001/jamaneurol.2020.0001
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: