Frequency and characteristics of MRI-negative myelitis associated with MOG autoantibodies
Elia Sechi, Karl N. Krecke, Sean J. Pittock, Divyanshu Dubey, A. Sebastian López‐Chiriboga, Amy Kunchok, Brian G. Weinshenker, Nicholas L. Zalewski, Eoin P. Flanagan
Abstract
BACKGROUND: Myelitis accompanied by a negative spinal cord MRI may lead to diagnostic uncertainty. OBJECTIVE AND METHODS: We retrospectively investigated the frequency of negative spinal cord MRI (performed <6 weeks from onset) in Mayo Clinic patients with myelin oligodendrocyte glycoprotein (MOG)-IgG-associated myelitis (2000-2019). RESULTS: The initial spinal cord MRI was negative in 7/73 (10%) patients, despite severe acute disability (median EDSS, 7 (range, 4.5-8)); myelitis symptoms/signs were frequent (paraparesis, neurogenic bladder, sensory level, Lhermitte's phenomenon). Myelitis lesions became overt at follow-up MRI in three patients. CONCLUSIONS: A negative spinal cord MRI should not dissuade from MOG-IgG testing in patients with acute/subacute myelitis.