Anti-NMDA-receptor encephalitis and MOGAD associated optic neuritis: a case series
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By
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Pooja Parthasarathi
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Michael Dattilo
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Jason Peragallo
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July 10, 2026
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Clinical Scorecard: A Case Series of Optic Neuritis in Patients with Anti-NMDA-Receptor Encephalitis and MOGAD
At a Glance
| Category | Detail |
|---|
| Condition | Optic Neuritis in Anti-NMDAR Encephalitis and MOGAD |
| Key Mechanisms | Co-occurrence of anti-NMDAR encephalitis and MOGAD, potentially due to epitope spreading. |
| Target Population | Patients with anti-NMDAR encephalitis and MOGAD. |
| Care Setting | Neurology and autoimmune disease management. |
Key Highlights
- Patients presented with altered mental status and vision loss.
- MRI showed abnormal T2/FLAIR lesions and optic nerve enhancement.
- All patients tested positive for CSF anti-NMDAR antibodies and serum MOG titers.
- Treatment included IV steroids, plasma exchange, IV immunoglobulin, and rituximab.
- Visual acuity improved to baseline levels following treatment.
Guideline-Based Recommendations
Diagnosis
- Diagnosis based on clinical presentation, MRI findings, and antibody testing.
Management
- Management includes IV steroids, plasma exchange, IVIG, and rituximab.
Monitoring & Follow-up
- Careful monitoring for new visual symptoms in patients with anti-NMDAR encephalitis.
Risks
- Risk of relapse in patients with dual autoimmunity.
Patient & Prescribing Data
Three patients with anti-NMDAR encephalitis and MOGAD.
Treatment regimens varied but included long-term maintenance therapies.
Clinical Best Practices
- Monitor for optic neuritis in patients with anti-NMDAR encephalitis.
- Consider dual autoimmunity in patients presenting with overlapping symptoms.
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