Anti-Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Disease Presenting with Severe Dystonia

Abstract Background Anti-MOG disease typically manifests with optic neuritis and transverse myelitis. Less common manifestations are aseptic meningitis and seizures. We report a very young child with severe dystonia, a novel clinical presentation for anti-MOG disease. Case presentation A 3-year-old boy presented with new onset seizure preceded by malaise and fever. MRI showed multifocal brain and spinal cord lesions, most prominently in bilateral insula and putamen. He developed severe orofacial and limb dystonia. In this case report we show a video presentation of his abnormal movements, and we discuss his treatment and outcomes. Conclusion This report highlights the novel spectrum of manifestations associated with MOG antibody disease and argues that it should always be considered in the differential diagnosis of a child with an acute neuro-immunological process.