CNS inflammatory demyelinating disorders: MS, NMOSD and MOG antibody associated disease

J Investig Med. 2020 Feb;68(2):321-330. doi: 10.1136/jim-2019-001126. Epub 2019 Oct 3.


Although Multiple Sclerosis is the most common central nervous system (CNS) inflammatory demyelinating disorder, other CNS inflammatory disorders should be included as diagnostic considerations. Neuromyelitis Optica Spectrum Disorder (NMOSD) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease are less common but share some clinical characteristics, such as optic neuritis and myelitis, which can make a specific diagnosis challenging. However, these disorders have distinctive and generally different clinical phenotypes, prognosis and management. It is imperative to distinguish each from one another, especially since the treatments (not discussed in this review) can be different. The advent of reliable testing for anti-aquaporin-4 for NMOSD and anti-MOG antibodies has helped significantly; however, diagnosis can remain challenging, especially in sero-negative cases. Clinical indicators are important to guide diagnostic work-up. Careful review of the history, neurological exam, imaging, and/or spinal fluid results are essential to making an accurate diagnosis. In this review, we will examine the clinical presentation, diagnosis, and natural history of these inflammatory CNS disorders.

Keywords: multiple sclerosis; myelin oligodendrocyte (MOG) antibody associated disease; neuromyelitis optica spectrum disorder.

Publication types

  • Review

MeSH terms

  • Autoantibodies / blood*
  • Demyelinating Autoimmune Diseases, CNS / blood
  • Demyelinating Autoimmune Diseases, CNS / diagnostic imaging
  • Humans
  • Multiple Sclerosis / blood*
  • Multiple Sclerosis / diagnostic imaging*
  • Myelin-Oligodendrocyte Glycoprotein / blood*
  • Neuroimaging / methods
  • Neuromyelitis Optica / blood*
  • Neuromyelitis Optica / diagnostic imaging*


  • Autoantibodies
  • MOG protein, human
  • Myelin-Oligodendrocyte Glycoprotein