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Bilateral Internuclear Ophthalmoplegia: Multiple Sclerosis rather Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)?

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Bibliographic Details
Summary:Increasing knowledge about neuro-inflammatory conditions as lead to new challenges in establishing a diagnosis. Clinical distinctive features might help. We present a 34-year-old patient with bilateral internuclear ophthalmoplegia (bINO). Investigation was compatible with demyelinating central nervous system (CNS) disease. Low-positive IgG myelin oligodendrocyte glycoprotein (MOG) antibodies were found. Rituximab was started and the patient has remained without further clinical or magnetic resonance imaging (MRI) activity. Acknowledging that bINO is a wellknown manifestation of multiple sclerosis (MS) but rarely reported among MOGAD patients its occurrence might help distinguish MS from MOGAD in an apparent overlap setting, favoring MS.
Main Authors:Marques, Ana João
Other Authors:Matas, Andreia; Gabriel, João Paulo
Subject:Esclerose Múltipla Glicoproteína Mielina- Oligodendrócito Oftalmoplegia Multiple Sclerosis Myelin-Oligodendrocyte Glycoprotein Ophthalmoplegia
Year:2025
Country:Portugal
Document type:article
Access type:unknown
Associated institution:Sociedade Portuguesa de Neurologia
Language:English
Origin:SINAPSE
Description
Summary:Increasing knowledge about neuro-inflammatory conditions as lead to new challenges in establishing a diagnosis. Clinical distinctive features might help. We present a 34-year-old patient with bilateral internuclear ophthalmoplegia (bINO). Investigation was compatible with demyelinating central nervous system (CNS) disease. Low-positive IgG myelin oligodendrocyte glycoprotein (MOG) antibodies were found. Rituximab was started and the patient has remained without further clinical or magnetic resonance imaging (MRI) activity. Acknowledging that bINO is a wellknown manifestation of multiple sclerosis (MS) but rarely reported among MOGAD patients its occurrence might help distinguish MS from MOGAD in an apparent overlap setting, favoring MS.