Study of Clinical, Radiological and Laboratory Features in Neuromyelitis Optica Spectrum Disorder and Myelin Oligodendrocytes Glycoprotein Associated Disorder at a Tertiary Care Hospital in India

A BSTRACT Introduction: Neuromyelitis optica spectrum disorders (NMOSD) and Myelin oligodendrocytes glycoprotein antibody-associated disease (MOGAD) are two important central nervous system demyelinating disorders. Although the two diseases share many features in common, yet they are two different diseases with different neuropathogenetic mechanisms and clinical and radiological pictures. Material and Methods: It was a prospective cross-sectional observational study at a tertiary care hospital. 43 patients were enrolled over 3 years. 26 patients were of NMOSD (23 seropositive and 3 seronegative) and 17 patients were of MOGAD. The clinical, radiological, and laboratory profiles of both groups were studied and compared. Results: Over all 44 percent of the patients were in 3rd decade in both groups. In MOGAD occurrence in 2 nd decade was next common. Female sex preponderance was seen in females (61 %) while male sex was predominant in MOGAD (70%). LETM (longitudinally extensive transverse myelitis) was the most common initial clinical presentation in NMOSD (27%) and unilateral ON (optic neuritis) in MOGAD (41%). 9 patients of NMOSD had 31 relapses and 6 patients of MOGAD had 12 relapses. Clinical features on relapse were retained in 55% of cases in both groups. Area postrema lesions were seen in the NMOSD exclusively. Conus involvement was more common in MOGAD (22%). Anterior segment ON was more common in MOGAD while intracranial and canalicular involvement was more common in NMOSD. The cervical cord was more commonly involved in NMOSD and the cervico-dorsal region in MOGAD. LEON (longitudinally extensive optic neuritis) was as common in both. Conclusion: NMSD and MOGAD share many clinical, radiological and lab features but there are some differences.The findinga are important specially in seronegative cases.