Abstract
Introduction: Myelin Oligodendrocyte Glycoprotein antibody disease (MOGAD) has a variable clinical presentation, with ADEM being the most frequent phenotype in younger pediatric patients and optic neuritis and transverse myelitis in older patients. The NMOSD-like phenotype includes episodes of optic neuritis and/or transverse myelitis with or without brainstem syndromes. Case presentation: An 11-year-old male patient presented with symptoms of optic neuritis, followed by two brainstem syndromes with cerebellar involvement, and negative aquaporin 4 antibodies (AQP4) and oligoclonal bands, with positive MOG antibodies. He was treated in the acute stage with intravenous corticosteroid with adequate response. Conclusions: MOGAD should be suspected in pediatric patients with demyelinating syndromes, and MOG antibodies should be requested, especially in patients with negative AQP4 antibodies and oligoclonal bands. Early diagnosis and maintenance therapy is important to prevent recurrences, avoid sequelae, and improve the quality of life of these patients.
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