Anti-MOG antibody disease (MOGAD): MRI features

Spinal cord features (myelitis)

• Longitudinally extensive transverse myelitis (LETM)
• Longitudinally extensive spinal cord atrophy
• Conus medullaris lesions: at disease onset
• The H sign
• The MRI may be normal

Optic nerve features

Cerebral hemisphere features

Absent features which differentiate from multiple sclerosis (MS)

Radiological differentials

References

1. Jarius S, Paul F, Aktas O, et al. MOG encephalomyelitis: international recommendations on diagnosis and antibody testing. J Neuroinflammation 2018; 15:134.
2. Symmonds M, Waters PJ, Küker W, Leite MI, Schulz UG. Anti-MOG antibodies with longitudinally extensive transverse myelitis preceded by CLIPPERS. Neurology 2015; 84:1177-1179.
3. Abdulla MC. Myelin oligodendrocytes glycoprotein antibody-positive longitudinally extensive myelitis with owl's eye sign mimicking acute anterior spinal artery Ischemia. Ann Indian Acad Neurol 2022; 25:931-932.
4. Sahoo D, Dash A, Dey A, Devi S. Myelin oligodendrocyte glycoprotein (MOG) antibody-associated longitudinally extensive transverse myelitis (LETM) and primary Sjogren syndrome: a rare association. BMJ Case Rep 2022; 15:e249915.
5. Ortiz SA, Perilla LAC, Capera APG. The "H sign" in MOGAD myelitis. Neurol Sci 2025; 46:4771-4772.
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Related checklists

• Anti-MOG antibody disease (MOGAD): CSF features
• Anti-MOG antibody disease (MOGAD): treatment