Seizures in Chinese Patients with Myelin Oligodendrocyte Glycoprotein Encephalomyelitis: A retrospective study in single center

Background: Myelin oligodendrocyte glycoprotein (MOG) antibody associated encephalomyelitis is increasingly being considered a distinct disease entity, with seizure and encephalopathy commonly reported. Object: To investigate the clinical features of MOG-IgG positive patients with seizures and /or encephalopathy in a single cohort. Methods: Overall, 58 patients seropositive for MOG-IgG, including 23 paitents with seizures and/or encephalopathy and 35 patients without seizures or encephalopathy were included. Results: The incidence of seizures and/or encephalopathy was 39.66% (23/58). Either at disease onset or throughout the course of disease, meningeal irritation (P=0.030, P=0.011), fever (P=0.001, P=0.000), headache (P=0.001, P=0.000), nausea and vomiting (P=0.004, P=0.000) were significantly higher in patients with seizures and/or encephalopathy than the control group. There was less optic nerve (P=0.003) and spinal cord (P=0.037) involvement in the patients with seizures and/or encephalopathy. CSF leukocytes were elevated in both seizures and/or encephalopathy group and the control group. Most of MOG encephalomyelitis patients had cortical/subcortical lesions, including 65.2%(15/23) in the seizures and/or encephalopathy group and 50.0%(13/26) in the control group. Subgroup analysis showed that 30%(7/23) MOG-IgG positive subjects with seizures and/or encephalopathy had been misdiagnosed for central nervous system infection due to meningoencephalitis symptom and elevated CSF leukocytes (P=0.002). Conclusions: Seizures and encephalopathy are not rare in MOG encephalomyelitis, which may be associated with cortical/subcortical brain lesion. MOG encephalomyelitis patients often combined meningoencephalitis symptom and abnormal CSF presentation, mimic CNS infection.