FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES) in a patient with Crohn's disease on anti-TNF treatment.

Abstract

The FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES) were first described by Ogawa et al. in 2017 as a distinctive clinical-radiological syndrome from other anti-MOG antibody-associated demyelination syndromes, often with a more indolent course. The most frequent clinical manifestations of this syndrome are seizures, headache, fever, and focal cortical deficits congruent with the localization of unilateral cortical FLAIR hyperintense lesions, although bi-hemispheric involvement is not uncommon. The etiology and risk factors for developing the syndrome remain unknown. Some cases have been associated with concomitant anti-NMDAR antibodies, but the association of anti-MOG-related disorders with other autoimmune diseases seems rare. Recently, a case of FLAMES in a patient with inflammatory bowel disease (ulcerative colitis) on TNF inhibitor therapy has been reported.