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).