Diagnostic and treatment challenges in MRI-negative myelitis associated with MOG antibody: A case report and literature review.

Background: MRI negative cases of anti-MOG-seropositive longitudinally extensive transverse myelitis (LETM), optic neuritis and encephalitis have been reported in the literature. Negative MRI can lead to diagnostic uncertainties and treatment delay. Objectives: We report a case of a patient with LETM with negative spinal MRI who tested positive for serum MOG antibody and showed continuous improvement with immunotherapy. Conclusion: Negative spinal cord MRI in patients with clinical presentation of LETM or transverse myelitis should not preclude investigation of MOG Antibody associated disease and initiation of early empirical immunotherapy.