Unmasking myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): CNS demyelination triggered by TNF-alpha Inhibition in a patient with ankylosing spondylitis

Clinicians should maintain a high index of suspicion for MOGAD in patients with atypical neurological symptoms, even when MRI findings are negative.TNF-α inhibitors may act as potential immunologic triggers for central nervous system demyelination, especially in patients with autoimmune conditions.Strong MOG antibody positivity can guide diagnosis in diagnostically ambiguous presentations and warrants the timely initiation of immunotherapy.