Atypical myelin oligodendrocyte glycoprotein antibody disease presenting with isolated elevated intracranial pressure

Summary Background: There have been no described cases of myelin oligodendrocyte glycoprotein antibody disease (MOGAD) in a pediatric patient presenting with symptoms and signs of elevated intracranial pressure (ICP) and initially unremarkable magnetic resonance imaging (MRI). Case: We present a case of an obese, otherwise healthy 12-year-old male with headaches and double vision who had bilateral papilledema and cranial nerve VI palsies on examination. His initial MRI was remarkable only for findings consistent with increased ICP. Lumbar puncture demonstrated elevated opening pressure and pleocytosis. MOG titer was 1:10,000. Discussion: This case provides further evidence of the broad spectrum of MOGAD phenotypes.