This study aims to describe the clinical and radiological features of anti-MOG associated CCE and provide guidance for treatment and follow-up.

A total of 18 patients (10 males, 8 females) from 11 centers were included in the study, with a median age at onset of 22 years (IQR: 16,3). The median follow-up duration was three years (IQR: 7,5). At presentation, cortical findings were observed in four patients (22%), optic neuritis in seven (38%), encephalopathy in two (11%), brainstem involvement in 12 (56%), and spinal involvement in two (11%) patients. Acute treatments consisted of intravenous methylprednisolone (IVMP) in 11 patients (61%), plasma exchange in three (17%), and a combination of IVMP, plasma exchange, and IVIG in one patient (6%). Complete recovery was achieved in 13 patients (72%), partial recovery in four (22%), while one patient did not show improvement. During the follow-up period, 22% of the patients experienced a single attack, 56% had two attacks, and 22% had more than two attacks. Seizures occurred in 78% of patients, optic neuritis in 39%, and spinal attacks in 28%. Spinal lesions were identified in 33% of the patients, with 22% presenting cervicothoracic lesions, and 5.6% having either cervical or full spinal lesions. After six months of treatment, cortical lesions resolved in 14 patients (78%). The median final EDSS score was 2.0 (IQR: 3,5).

Anti-MOG associated CCE cases are limited in the literature. Early recognition in young patients with seizures, headaches, and altered consciousness is crucial for proper management and differentiating CCE from other encephalitis forms.