Tumefactive Demyelination in Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease

Myelin oligodendrocyte glycoprotein associated disease (MOGAD) includes a variety of presentations, and one of the less common is tumefactive brain lesions. Investigators retrospective analyzed 194 patients with MOGAD, 359 with aquaporin-4 antibody positive (AQP4+), and 49 with multiple sclerosis (MS) with ≥1 MRI brain lesion with maximum diameter of ≥2 cm.

Tumefactive lesions were found in 22% of MOGAD patients and 5% of AQP4+ patients. Compared with AQP4+ and MS patients, clinical features in MOGAD more often included headaches and somnolence. MRI lesions in MOGAD patients were less likely to have a T2 hypointense rim, T1 hypointensity, diffusion restriction, ring enhancement, or Balò-like appearance than in MS patients. On follow-up imagi…