Anti-mog associated encephalitis: when steroid therapy is not enough

MOG-antibodies are consistently identified in a variety of acquired demyelinating syndromes. In children, the most common presenting phenotype is acute disseminated encephalomyelitis, an immune-mediated disease characterized by demyelination and multifocal neurologic symptoms which typically occur after a preceding viral infection or recent immunization. Herein, we report the case of a 7-year-old boy who developed the first episode of MOG associated encephalitis, which was treated with steroid therapy, and after 6 months, presented a relapse of ADEM in which steroid treatment was not decisive, as he presented new symptoms with unchanged MRI lesions. For this reason, we decided to submit the boy to immunoglobulin intravenous therapy each month. The child has been followed up for 1 year and no new episodes have been reported.