MOGAD

Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease (MOGAD) 

What is MOGAD? 

MOGAD is a rare autoimmune condition where the immune system mistakenly targets a protein called MOG, found on the surface of nerve cells in the brain, optic nerves, and spinal cord. 

While MOGAD can seem similar to MS or NMOSD at first, it is a separate condition with its own patterns and treatment needs. It affects both adults and children, and many people recover well with the right support.  

In 2023, an international group of experts released new diagnostic criteria to help doctors identify MOGAD more accurately. These rely strongly on a blood test for MOGIgG antibodies.  

Common Symptoms

Optic Neuritis

This is the most common MOGAD symptom and can involve:

  • Blurry or cloudy vision
  • Eye pain with movement
  • Washed-out colours
  • Vision loss in one or both eyes (often both in MOGAD)

    • Spinal Cord Symptoms (Myelitis)

  • Weakness in arms or legs
  • Numbness, tingling, or buzzing sensations
  • Difficulty walking
  • Bladder or bowel changes

    • Brain-related Symptoms

    More common in children:

  • Headache or confusion
  • Behavioural changes
  • Seizures
  • ADEM (a sudden, widespread inflammatory episode often linked to infection)
    • The good news is that many MOGAD brain and spinal lesions improve or even fully resolve over time, especially in children.

    How is MOGAD Diagnosed?

    Doctors consider: 

    • Your symptoms 
    • MRI scans of your brain, optic nerves, and spinal cord 
    • A MOGIgG antibody blood test, using a specialised cell-based assay. Clear positive MOG IgG results are highly reliable. Low positive results are interpreted carefully to avoid misdiagnosis. Testing as early as possible improves accuracy 
    • Ruling out MS or AQP4-positive NMOSD 
    • Sometimes a lumbar puncture or imaging of other parts of your body is required 

    Treatment

    Treating an attack 

    If vision suddenly changes, weakness develops, or new symptoms appear, please seek urgent medical care. Early treatment makes recovery more likely.  

    The majority of people with MOGAD respond very well to steroids, often with rapid improvement. Most attacks are treated quickly with high-dose steroids to reduce inflammation.  
    If needed, doctors may also use: 

    • Plasma exchange 
    • IVIg (intravenous immunoglobulin) 

    Preventing Relapses

    Not everyone will have more than one attack. Many children, and some adults, never relapse. Currently there are no reliable tools that can help doctors predict whether someone is likely to have further attacks. However, some studies show that patients are more likely to have another attack in the first three to six months after an initial attack, especially if they stop steroid medication quickly. For this reason, many doctors will treat a new attack with high-dose steroids, followed by a slow taper of steroids over 3+ months.  

    For those who experience recurrent attacks, long-term treatment may include: 

    • Oral medications like prednisone (a steroid tablet), mycophenolate mofetil, or azathioprine. Although these medications are not specifically for MOGAD, there is some evidence that these oral medications can help reduce the chances of further attacks of MOGAD. 
    • Medications given by infusion like rituximab. These medications modify the immune system to try and reduce the amount of MOG-IgG that is produced by the body.  
    • Intravenous immunoglobulin (IVIg), has also been shown to reduce relapses more effectively than some other treatments used in MOGAD.  
    • Newer therapies like tocilizumab, also a medication given by infusion. Tocilizumab is currently not approved or funded by Pharmac for MOGAD.  
    • Avoiding MS medications which do not work in MOGAD 


    Your neurologist will work with you to find the most suitable plan.

    Living with MOGAD

    Have a plan – quick steroid treatment often leads to better recovery, knowing who to contact if symptoms flare is important.  

    Vision care – optic neuritis can be frightening, but many people recover well. Orthoptic support and low-vision strategies can help you adjust while healing. 

    Mobility and rehabilitation – physiotherapy and OT can support strength, pacing, and returning to daily activities. 

    Regular blood tests and monitoring is important, especially if you are on long-term preventative therapies. These treatments can weaken the immune system and make you more vulnerable to infection.  

    For tamariki and families 

    Children may need: 

    • Gentle returntoschool plans 
    • Support for concentration, fatigue, or sensory overload 
    • Shared information with teachers 


    The MOG Project provides excellent child-friendly fact sheets for schools.     MOGAntibodyDiseaseFactSheetForEducators021222.pdf 

    Community & Connection

    Many people find confidence and comfort in connecting with others living with MOGAD. 

    The MOG Project Community is especially active and supportive. Join the community and help others in need. 

    Learn More

    • The MOG Project (brochures, videos, school resources, community support) (Mog Project)