Myelitis
Myelitis is the second most common clinical presentation in adult MOGAD patients, accounting for around 20% of disease-related attacks, while it is less common in children (9,25,36). LETM, defined as a spinal cord lesion spanning three or more vertebral segments in length, is a common finding in MOGAD (41). Typical symptoms include motor and/or sensory deficits (numbness), bladder, bowel, and/or erectile dysfunction (41). Neuropathic pain has been implicated in NMOSD to be related to the level(s) at which spinal cord lesion(s) are located, which could be the case in MOGAD patients as well, since the 86% of MOGAD patients in one study reportedly suffered from chronic pain (42–45). Clinical differences distinguishing myelitis in MOGAD vs. MS or AQP4-NMOSD are: a higher percentage of patients are male, frequency of bladder and erectile dysfunction, younger age, prodromal infection and concurrent ADEM. However, short myelitis can also occur and is found in up to 38% of MOGAD cases (46,47). Unsurprisingly, bladder dysfunction has been found to be more prevalent in MOGAD patients with LETM compared to those with short myelitis (47).