Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune disorder. It occurs when your immune system mistakenly attacks myelin oligodendrocyte glycoproteins found in the myelin sheath, the protective cover that surrounds the nerves in your brain, spinal cord, and eyes.
The myelin sheath allows electrical signals to travel between your brain and the rest of your body. Damage to the myelin sheath in MOGAD leads to neurological symptoms, including muscle weakness, vision loss, confusion, and loss of coordination.
UPMC experts provide advanced care for MOGAD, including treatment with medication, plasma exchange, or intravenous immunoglobulin therapy (IVIG).
On this page:
What Is MOGAD?
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune disorder that occurs when your immune system mistakenly attacks myelin oligodendrocyte glycoproteins found in the myelin sheath. This protective cover surrounds the nerves in your brain, spinal cord, and eyes.
The myelin sheath allows electrical signals to travel between your brain and the rest of your body. Damage to the myelin sheath in MOGAD leads to neurological symptoms, including muscle weakness, vision loss, confusion, and loss of coordination.
Is MOGAD the same as multiple sclerosis (MS)?
MOGAD and MS are both demyelinating disorders that cause damage to the myelin sheath. However, they are distinct conditions with different characteristics.
MOGAD is a rare condition that is often associated with severe optic nerve damage in both eyes. MS is a more common condition that causes brain and spine lesions.
What are the types of MOGAD?
There are two types of MOGAD, including:
- Monophasic MOGAD — Causes a one-time attack of symptoms.
- Relapsing MOGAD — Causes symptoms that go into remission (go away) and relapse (come back).
How common is MOGAD?
MOGAD is a rare disorder. Although researchers aren’t sure how many people are living with MOGAD, estimates suggest it affects one to three people per million in the U.S. each year.
What causes MOGAD?
Researchers aren’t sure what causes MOGAD. It is not an inherited or genetic disorder.
Complications of MOGAD
MOGAD complications may include:
- Bladder or bowel problems.
- Blindness.
- Chronic fatigue.
- Difficulty with thinking, memory, learning, and reasoning.
- Pain.
- Paralysis.
How can I prevent MOGAD?
There is nothing you can do to prevent MOGAD. However, if you have already been diagnosed with MOGAD, ongoing treatment and follow-up care may reduce your risk of relapse.
What Are the Signs and Symptoms of MOGAD?
MOGAD symptoms affect your eyes, spinal cord, and brain. Symptoms may come and go with long symptom-free periods or occur only once.
Most people are diagnosed with MOGAD in their 20s or 30s, but it can affect people of any age. Children are typically diagnosed before age 11.
MOGAD also affects adults and children differently. Children are more likely to experience brain and eye symptoms, while adults are more likely to experience spinal cord and eye symptoms.
MOGAD symptoms may include:
Eye symptoms
Also known as optic neuritis, eye symptoms can affect one or both eyes and may include:
- Blurry vision.
- Double vision.
- Eye pain.
- Loss of color vision.
- Vision loss.
Spinal cord symptoms
Also known as transverse myelitis, spinal cord symptoms may include:
- Loss of bowel or bladder control.
- Muscle weakness.
- Numbness.
- Pain.
- Spasticity (stiffness).
- Tingling.
Brain symptoms
Also known as acute disseminated encephalomyelitis (ADEM), symptoms that affect your brain may include:
- Balance and coordination issues.
- Behavior changes.
- Confusion.
- Headache.
- Loss of consciousness.
- Seizures.
When should I see a doctor about my MOGAD symptoms?
If you have symptoms of MOGAD, you should schedule an appointment with your doctor right away. If symptoms are severe, dial 911 or visit the nearest hospital Emergency Department. Getting early treatment can reduce your risk of experiencing serious complications.
How Do You Diagnose MOGAD?
To diagnose MOGAD, your doctor will perform physical and neurological examinations and review your symptoms and medical history. Your doctor may also order tests to confirm your diagnosis or rule out other problems.
What to expect during your visit
During your visit, your doctor will:
- Ask you about your symptoms.
- Order tests.
- Perform a physical and neurological exam.
- Review your medical history.
Tests to diagnose MOGAD
Tests to diagnose MOGAD include:
- Blood tests — Check for signs of MOGAD and rules out other conditions.
- Cerebral spinal fluid analysis (spinal tap or lumbar puncture) — Involves inserting a needle into your lower back to collect a sample of cerebrospinal fluid (CSF) for analysis in a lab.
- Electromyography (EMG) — Sometimes called an electromyogram, an EMG allows a doctor to record and study the electrical activity of your muscles.
- Magnetic resonance imaging (MRI) — Creates images of your brain and spine using contrast dye to look for damaged or abnormal areas.
- Nerve biopsy — A procedure to take a sample of one of your nerves to look for damage to the myelin sheath.
- Nerve conduction study (NCS) — Measures the speed of electrical activity passing through your nerves.
- Neurological examination — A noninvasive test to check your reflexes, balance, movement, memory, and ability to think.
- Vision exam — Checks your eyesight and the overall health of your eyes.
MOGAD prognosis
Although there is no cure for MOGAD, many people recover well with treatment. In some cases, MOGAD causes permanent vision changes. You may also experience complications caused by treatment-related side effects, such as infections due to long-term immune system-suppressing therapy.
How serious is MOGAD?
MOGAD is a serious disease that can cause long-term vision or mobility problems if left untreated. However, with early diagnosis and treatment, it is possible to recover and reduce the risk of recurrence.
What is the life expectancy of someone with MOGAD?
Most people with MOGAD have an average life expectancy.
How Do You Treat MOGAD?
There is no cure for MOGAD. However, the goals of treatment are to reduce the risk of complications, relapses, and permanent damage.
Treatment for acute (sudden onset) MOGAD symptoms
Treatment options for acute MOGAD symptoms include:
- Intravenous immunoglobulin therapy (IVIG) — Involves intravenous injection of donor immunoglobulins, which are a natural part of your immune system and protect your body by attacking foreign organisms. Immunoglobulins may prevent your immune system from further damaging your nerves.
- Medications — Intravenous (IV) steroids help to treat inflammation and oral immunosuppressant medications help to calm your overactive immune system.
- Plasmapheresis (plasma exchange) — Uses a machine to separate the liquid part of your blood, called plasma, from your blood cells. Your plasma is then filtered to remove the antibodies that cause nerve damage before being returned to your body.
Treatment options to reduce MOGAD relapse risk
Long-term treatment options to reduce the risk of MOGAD relapse include:
- Medications — Uses long-term medications to suppress your immune system.
- IVIG — Immunoglobulins are given by infusion or injection.
Rehabilitation
During your recovery, you may receive different types of rehabilitation therapy to help you regain strength, mobility, and independence.
Rehabilitation treatment may include:
- Occupational therapy — Teaches techniques and strategies to help you perform everyday activities, such as bathing, dressing, cooking, and grooming, sometimes with the assistance of a cane, brace, walker, or wheelchair.
- Physical therapy — Improves strength, balance, and mobility using exercises, stretching, massage, electrical stimulation, and other techniques.
- Speech and swallowing therapy — Helps you regain the ability to chew, swallow, and speak.
- Vision therapy — Teaches you techniques to strengthen your vision or cope with permanent vision problems.
Clinical trials
You may be eligible to participate in a clinical trial studying new treatments for MOGAD. Your doctor will let you know if you qualify for a clinical trial.
Why Choose UPMC for MOGAD Care?
When you choose UPMC for MOGAD care, you will receive:
- Multidisciplinary care — Our team of neurologists and autoimmune disease experts will work together to develop a customized treatment plan that reduces your risk of complications.
- Access to advanced clinical trials — Our team participates in national, multicenter clinical trials evaluating new treatment options, allowing you to contribute to research advancing care for autoimmune disorders.
- Seamless, ongoing treatment — If you are diagnosed with MOGAD, our team will develop a plan for your follow-up care, including ongoing rehabilitation and treatment as needed.
