Atypical MOG antibody disease presenting with typical multiple sclerosis lesions

Myelin oligodendrocyte glycoprotein (MOG) antibody disease is an autoimmune disease of the central nervous system associated with a serological antibody against MOG, a glycoprotein expressed on the outer membrane of myelin. It is solely found within the central nervous system in the brain, optic nerves and spinal cord. MOG antibody disease falls within the neuromyelitis optica spectrum disorders (NMOSD), however clinical characteristics appear distinct from aquaporin-4 antibody related disease and multiple sclerosis. It has predilection for causing recurrent optic neuritis and transverse myelitis. Accurate diagnosis is important to determine long term prognosis and suitable treatment. We describe the case of a 42 year old woman previously labelled as MS who demonstrated a variable presentation of MOG antibody disease.