Brain and spine MRI of a child with acute disseminated encephalomyelitis (ADEM) and MOG antibody-associated disease (MOGAD)

A five-year-old child diagnosed with anti-MOG positive, multiphasic ADEM with optic neuritis. At presentation, MRI revealed multiple lesions in the periventricular and subcortical white matter (A, B) and the left middle cerebellar peduncle (C) lesions. One month later, there was complete resolution of lesions on MRI (D, E). Four years later, optic neuritis was diagnosed. MRI showed T2-hyperintense lesions in optic chiasm (F, rectangle) and a FLAIR-hyperintense lesion (G, arrow) and patchy enhancement (H, circle) of the intracranial optic nerves. Eight years later, the patient presented with myelitis, and MRI of the spinal cord showed T2-hyperintense lesions on sagittal (I) and axial (J) sequences, consistent with longitudinally extensive transverse myelitis.