European Journal of Biomedical and Pharmaceutical Sciences

A COMPREHENSIVE CASE STUDY OF MYELIN OLIGODENDROCYTE GLYCOPROTEIN ASSOCIATED ENCEPHALITIS

Shabik K.* and Devika K.

ABSTRACT

A 54-year-old male was admitted on May 16th with a one-week history of giddiness, worsening headache, and blurred vision over the past three days, alongside a single episode of vomiting, mild right-sided walking difficulty, decreased memory, and altered behavior. He had no known prior medical conditions. On admission, his vitals were stable, and his GCS score was E4V5M6. Neurological examination showed no ataxia, and Romberg's test was negative. His lipid profile revealed low HDL (44 mg/dL) and high LDL (122 mg/dL), while liver function tests showed an elevated AST level (44 U/L). MRI of the brain indicated gyral thickening with FLAIR hyperintensity in the left posterior parieto-occipital and temporal lobes, with a chronic lacunar infarct in the right lentiform nucleus. The diagnosis included MOG-associated encephalitis, occipital blindness, and newly diagnosed type 2 diabetes mellitus. He developed hypertension (160/100 mm Hg), restlessness, and visual hallucinations, and was treated with antihypertensive and antidiabetic medications, eye drops, and antidepressants. Over the following days, he continued to experience headaches, reduced appetite, unformed stools, and blurred vision. His treatment was adjusted to include corticosteroids, NSAIDs, antibiotics, and additional antidiabetic drugs. EEG revealed mild focal dysfunction in the left occipital region. As his condition stabilized, certain medications were withdrawn or adjusted, including the addition of Vildagliptin and Mycophenolate mofetil. By the seventh day, his symptoms had improved, and he was discharged with a prescribed medication regimen that included antibiotics, corticosteroids, antidiabetics, eye drops, and pain relievers.

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