Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of recurrent myelitis associated with anti-myelin oligodendrocyte glycoprotein antibody that developed only as localized short spinal cord lesions

Arifumi Matsumoto, M.D., Ph.D.1), Kimihiko Kaneko, M.D.2), Toshiyuki Takahashi, M.D., Ph.D.2)3), Ichiro Nakashima, M.D., Ph.D.2)4), Kinya Hisanaga, M.D., Ph.D.1) and Isao Nagano, M.D., Ph.D.1)

1)Departments of Neurology and Clinical Research Center, National Hospital Organization, Miyagi Hospital
2)Department of Neurology, Tohoku University Graduate School of Medicine
3)Department of Neurology, National Hospital Organization, Yonezawa Hospital
4)Department of Neurology, Tohoku Medical and Pharmaceutical University

A 65-year-old man initially developed numbness and hypesthesia in the right shoulder and brachial regions that disappeared within several months. MRI revealed a small lesion extending to a vertebral segment in the right dorsal region of the cervical spinal cord at the vertebral height of C2/3. About 15 months later, the intermittent lancinating pain identical to the right trigeminal and occipital neuralgia with pain and hypesthesia distributed in the right C2-C4 dermatome regions appeared. MRI revealed a new oval lesion with gadolinium enhancement in the right dorsal region of the cervical spinal cord at the vertebral height of C1, which was thought to involve the posterior column and lower part of the spinal tract nucleus of the trigeminal nerve. There was no optic nerve, brain, or other spinal cord lesions that suggested demyelination on MRI. A titer of serum anti-aquaporin-4 antibody was negative, but anti-myelin oligodendrocyte glycoprotein (MOG) antibody was found to be positive. The symptoms were relieved by corticosteroid treatment. Our report presents a rare case of anti-MOG antibody-positive recurrent myelitis that developed only as localized short upper cervical spinal cord lesions, not meeting the diagnostic criteria for neuromyelitis optica spectrum disorders.
Full Text of this Article in Japanese PDF (573K)

(CLINICA NEUROL, 57: 729|732, 2017)
key words: anti-MOG antibody, anti-AQP4 antibody, neuromyelitis optica spectrum disorders, multiple sclerosis, trigeminal neuralgia

(Received: 9-Feb-17)