“FLAMES: A novel burning entity in MOG IgG associated disease”

Abstract

FLAMES is a new clinico-radiological sub entity of myelin oligodendrocyte glycoprotein (MOG) antibody associated disease (MOGAD). FLAMES is characterized by fluid attenuated inversion recovery (FLAIR) imaging showing hyperintense cortical lesions, in MOG associated Encephalitis with Seizures. MOGAD usually presents with optic neuritis, myelitis or acute disseminated encephalomyelitis and such rare focal cortical encephalitis like presentation can be mistaken as due to viral aetiology. FLAMES can present with unilateral or bilateral cortical encephalitis and we report a case where magnetic resonance angiography, susceptibility weighted imaging and perfusion studies were done and the utility of these additional imaging markers in diagnosing FLAMES is discussed.