MOGAD (Myelin Oligodendrocyte Glycoprotein Associated Disease) Explained by Neurologist
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- čas přidán 5. 03. 2024
- 0:32 Symptoms/MRI
5:55 Pathophysiology
6:41 Anti-MOG-IgG
8:11 Epidemiology
9:39 Diagnostic Criteria
11:14 Prognosis
13:27 Pregnancy
13:38 Treatment (acute attacks)
15:14 Treatment (attack prevention)
22:09 Clinical Trials
Selected Sources:
Delimiting MOGAD as a disease entity using translational imaging: pubmed.ncbi.nlm.nih.gov/38333...
Dr. Eoin Flanagan’s video on MOGAD: • Myelin Oligodendrocyte...
Effectiveness of immunotherapies in relapsing myelin oligodendrocyte glycoprotein antibody-associated disease: pubmed.ncbi.nlm.nih.gov/38314...
Neuroimaging features in inflammatory myelopathies: A review: www.frontiersin.org/journals/...
Pregnancy and post-partum in patients with myelin-oligodendrocyte glycoprotein antibody-associated disease: pubmed.ncbi.nlm.nih.gov/36453...
The MOG antibody non-P42 epitope is predictive of a relapsing course in MOG antibody-associated disease: pubmed.ncbi.nlm.nih.gov/38290...
Radiological Features for Outcomes of MOGAD in Children: A Cohort in Southwest China: www.dovepress.com/radiologica...
CNS Demyelinating Attacks Requiring Ventilatory Support With Myelin Oligodendrocyte Glycoprotein or Aquaporin-4 Antibodies: www.neurology.org/doi/10.1212...
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): Clinical features and diagnosis: www.uptodate.com/contents/mye...
Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease: www.frontiersin.org/journals/...
Predictors of relapsing disease course following index event in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): www.sciencedirect.com/science...
Interleukin-6 Receptor Blockade in Treatment-Refractory MOG-IgG-Associated Disease and Neuromyelitis Optica Spectrum Disorders: pubmed.ncbi.nlm.nih.gov/34785...
Evaluation of treatment response in adults with relapsing MOG-Ab-associated disease: jneuroinflammation.biomedcent...
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Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
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he video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information. - Věda a technologie
I had bilateral optic neuritis with left eye being worse than right. A couple weeks before that i had banding from chest down was on fire. Then had urine retention. I went to specialist for vision loss and they said optic neuritis needed to see neuroopthamologist. Went to ER and had multiple test done with neurologist initially diagnosing me with nmo. That was February of 2017. Then the mog test came out and i tested positive for that. I was relapse free until September of 2023 when i had optic neuritis again as well as burning of feet and legs. I get rituximab infusion every 6 months. As well as ivig for low iGg levels. After this last relapse my neurologist increased my ivig dose.
Hopefully this video was helpful to you. I presume you tested negative for anti-Aquaporin 4.
@DrBrandonBeaber I don't remember what test I had. I was trying to look back thru my chart but I couldn't find it. I had so many different test done at that time.
my son was positive fir aquaporin 4 he just been diagnosed w MS four months ago, can u please tell me how bad is it to be positive and its negative effect on body, thanks a lot.. i follow u all time
The more we learn, the better you can treat us.
Ty for explaining this.
#Sharingiscaring
Thanks for spreading the word about MOGAD! I initially presented with bilateral optic neuritis in 2020. 8 months of steroids and then started IVIG, but relapsed with a transverse myelitis attack and lost sensation in my feet and leg after I received 2 vaccines at once. Tried Cellcept, but had to stop due to rare side effects. Now doing a combination of IVIG and Actemra and have been relapse-free with that combo for 2.5 years. 👍🏻💪🏻
This video was so helpful thank you!!!
The end of June 2023 I had left thigh numbness in the morning by evening time my entire left leg had numbness/paresthesia then that night I had a back spasm and my L torso went numb. It was very compartmentalized to L side and an inch below breast through foot.
I had multiple lesions in my spine. I feel very blessed that one of the dr tested me for this. I did high dose steroids that tapered off over three months.
None of the neurologist I have seen can really tell me anything about this, so I appreciate all the information.
Thank you for explaining so thoroughly!! My (then) 5-year old was experiencing recurring episodes of fever, extreme fatigue, neck pain, elevated WBC, and confusion/difficulty speaking in September 2022. Finally ended up with a 2-week hospital stay that revealed positive MOG antibody and lesions on her spine and brain (ADEM). We initially treated with steroids, which gave relief almost immediately. We got many neuro opinions in the months following and decided to do a 6-month course of iVig, which we finished in December 2023. Waiting to get her MOG level re-checked next week!
I had ADEM following my first Covid vaccination, treated with IV Prednisone and oral Prednisone. 9 months later Optical Neuritis in one eye, treated with oral Prednisone. Currently on Mycophenilate mofetil. I have positive MOGAD antibodies. Thank you for sharing your presentation.
Lorraine
Excellent video by the way. 👏🏻
Thanks
THNKS I have MS. It is interesting finding out all the different things that can happen in our brains.
Whoa!😮
Is this why i never responded to MS meds?
I had intense "ice pick" stabbing pain in my right eye back in 2005 (3 months after a car accident with head injury), and i couldn't feel where my feet were in space, so i took some good falls.
Fast forward a few more months.... neurologist and opthamologist.
High dose steroids & prednisone eye drops ( which im still on 20 years later), and troublesome neuropathy pain and burning of the feet.
Oligo bands present on spinal tap, but my Neurologist said my MRI's looked odd.
Hmmmmmm....
interesting!
Thank you for this amazing & thought provoking presentation. 😊❤😊
My daughter’s diagnosis was recently changed to MOG antibody disease. 2 years ago she had a partial seizure in her left hand that lasted 20 minutes or so that turned into a tonic clonic seizure that lasted 8 minutes. That was her only symptom. She was misdiagnosed with a suspected brain tumor and had a biopsy of the suspected lesion. It took awhile to get the biopsy back which showed she a demyelinating lesion. She had steroids post surgery and her follow up MRI showed complete resolution of the lesion. Her lesion was in her parietal lobe right next to the sensory cortex. She was unable to get a spinal because we discovered a Chiari malformation on her MRI. Also by the time we ran for MOG antibodies she was 7 weeks from the attack so they came back negative. Our new pediatric neuro specialist suspects MOG because of the how everything went but can’t be 100% certain. So far no relapses
I was recently diagnosed with MoGad Iwas started on Ampyra and seeing some improvement in my hair I had 2 lesion on my brain and a spine lesion last year Untreated for a year This year I now have 6/7 total brain lesions and no change on the thorastic lesion
I had right eye optic neuritis in 2010 which left me with severe optic disk atrophy. I was tested for ms and other pathologies, but it was left as no known cause. I had lots of neurological issues over the next 10 years with no diagnosis or treatment, but then had left eye optic neuritis in 2020. I was seen by a visiting neurologist whilst undertaking IV steroids treatment who referred me to another hospital for NMO. I underwent plasmapheresis for a course of 5 days and was diagnosed with MOGAD following positive antibody tests. My vision in the left eye improved a little, but not much, and I was left with a visual acuity of 6/60 and am now registered as blind. I have now been on Azathioprine for 4.5 years and have not had any further attacks. I am due to come off this in January and I'm terrified of returning to a relapsing state.
I started having ON and TM at age 6. TM recovered completely but ON continued to plague me until I was 14. Off and on steroid treatments and MRIs evert lly 6 months for ADarlEM/MS (they had no idea what it was) A year ago I relapsed again (at age 26) and was finally diagnosed with MOGAD. My original titers were 1:14 but after getting tested the other day (and being off Cellcept for a month) my titers were 1:100. I'm back on Cellcept and have an MRI and other tests scheduled, but he is hoping clinical trials will come up soon for our area in Dallas.
Good information thanks. I'm curious as to why MRI lesions in MOGAD resolve while they don't in MS. What is the mechanism that's different in the two diseases?
I don't know, but presumably there is more often permanent injury to the myelin/axons in multiple sclerosis, whereas in MOGAD it may be temporary swelling.
I was told MOGAD can heal without scarring which is less common with MS.
Good discussion in the 2021 paper in Neurology: Comparison of MRI Lesion Evolution in Different Central Nervous System Demyelinating Disorders (it's against Google policy to include links in comments).
Thank you for your videos! I've learned a lot from them over the last year, and this one was timely for me
What are possible alternative diagnoses for high MOGAD titers? I had a MOG Ab titer of 1:160 on a fixed cell based assay, was diagnosed with MOGAD, then was told by an expert just yesterday that it may be a false positive
Clinical history includes recurrent episodes of very blurry vision (sometimes but rarely with pain), sudden onset double vision (fully resolved for a couple years but now intermittent), extreme difficulty walking for a few months, and clumsiness (frequent trips / falls / dropping things / etc), but no related hospitalizations or ER visits. Father has PPMS. MRIs of brain, c-spine, and t-spine are clear
I can't comment on your personal situation. It would depend on whether or not the blurry vision were actually caused by optic neuritis.
@@DrBrandonBeaber Sorry, I meant the question to be broad - probably should have left out the history :) I trust my doctors to get to the right answer!
Thank you again for all your videos!
Is it possible that some people diagnosed with MS actually have MOGAD instead?
Yes, and if you look at the observational studies in the second half of the video, many participants were inappropriately diagnosed with MS and placed on multiple sclerosis drugs.
Two episodes of optic neuritis in 2003 and 2004, I was not diagnosed, only injections for the inflammation. 20 years without treatment in 2023 I got new episode of optic neuritis and now I have a diagnosis. I have been taking prednisone for 6 months and now my doctor says I can start with IVIG.
What about Clemanstine to help remyelination? Can you make a video about that?
Here you go: czcams.com/video/T6p5e2TcR9Q/video.html
@@DrBrandonBeaber thank you so much!
Hello and welcome. Dear Sir, is there a chance to add subtitles in Polish? Kind regards!
Thank you! Does the fact that IVIG works better than immunosupressive meds give any clues on causation of MOGAD?
Of course I believe the inflammation is primarily antibody/complement mediated, but I'm not sure why IVIG would be more effective than b-cell depleters. Perhaps there is a long therapeutic lag with b-cell depleters.
@@DrBrandonBeaber Thank you! As you mentioned, it occurs after infections or vaccinations. Is it possible that IVIG might boost immunity and that helps a little?
how can steroid treatment help?! Is the steroid kind of helping soup-up the body's own abilities to repair? And the withdrawal mentioned at 12:00 is showing that without the steroid boost a relapse is more likely? I had to listen at .75 speed as this is different than MS terms and topics though auto immune.
Steroids suppress the activity of white blood cells, reducing inflammation. As the steroids are withdrawal, the white blood cells regain activity and cause CNS inflammation. I am unsure why this phenomenon of steroid-rebound is more common in MOGAD.
5:25 to 5:28 was the switch in the time line?
Yes correct.
Hello, my name is Tony. I am currently in the hospital with a relapse of MOGAD. I just found out that I have MOGAD. About over a year ago I lost vision in my right eye so I came in to see what's going on, I was just on Predensone for 5 days then a addition 3 day out patient IV then I was put on pills. It helped. But now I'm experiencing it again in my left eye but I've been having problems with my left eyes for years, since after high-school. I never thought of getting it checked out but up until now they may seem to believe that I have this optic neuritis in my left eyes since then. I am now experiencing blury vision and lost of color in my left eye. I am currently on the iv steroid but have talked about the plasma exchange. They want to complete the 5 days of the IV, today is day 4 and still no changes.
Best of luck in your recovery.
Poor myelin it just doing it's job then boom ms, mog, adem, pml
Sir do you earn 600k dollars a year? Plz reply. Thanks a lot.
chill.
Thanks a bit forward in an obtuse way.
If you are sincere and you want to find out whether a particular neuro is receiving drug company money (which is actually a fair reasonable thing to wonder about re their possible conflicts of interest) there is a website which will reveal which exact monies, in what amounts were paid to whom, by whom and on what basis. Dr. Beaber is sponsored by Broccoli® and is as legit and sincere as they come.. so big respect to Dr. Beaber.
@@ernietollar407 I make $5 million a year just from the broccoli sponsorship alone
@@DrBrandonBeaber LOL 😂 We had broccoli last night. Lucky you! Cha ching
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