MOG antibodies

MOG antibody-associated demyelination and NMOSD

MOG stands for Myelin Oligodendrocyte Glycoprotein. MOG antibodies have been reported in some people who have transverse myelitis and/or optic neuritis and/or ADEM (acute disseminated encephalomyelitis) and AQP4 antibody negative NMOSD. However, their discovery is recent and there is much to be learned. MOG antibodies are found on the myelin sheath rather than the astrocyte as in AQP4 antibodies and cause damage to the myelin.

In contrast to typical NMOSD (caused by AQP4 antibodies) up to half of the persons with an episode of demyelination (e.g. optic neuritis) and  MOG antibodies often have a ‘one-off’ event and usually recover well from their illness

Treatment of MOG antibody associated disease

Since we are not sure about the natural course of the disease, treatment usually consists of a slow taper of corticosteroids (prednisolone) over 6 months to a year after the first event. If a relapse occurs then additional immunosuppressants (e.g. azathioprine) may need to be used much like we treat AQP4 antibody associated NMOSD.

When to test for MOG Antibodies

• AQP4 antibody negative NMOSD
• Recurrent, bilateral or severe optic neuritis Longitudinal or recurrent transverse myelitis
• ‘Atypical MS’ or other uncharacterized CNS demyelination
• Unexplained ‘encephalitis’ and seizures with brain lesions

Don’t test for MOG

• If typical of relapsing MS
• If AQP4 antibody is present
• If another obvious and definite diagnosis is present

If the test is positive, please refer the patient into one of the NMOSD centres.
If you have any questions regarding diagnosis or management, please refer to the NMOSD service.