Seizure occurrence in myelin oligodendrocyte glycoprotein antibody-associated disease: A systematic review and meta -analysis

Objective: Recent reports have suggested that seizures may be a component of the clinical presentation in myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease. We aimed to conduct a systematic review and meta -analysis to comprehensively evaluate the occurrence of epileptic seizures in the disease. Methods: We searched PubMed, MEDLINE and EMBASE for studies reporting the occurrence of acute sympto- matic seizures in MOG-Ab-associated disease. Fixed or random e ffects model was used to pool results across studies with a meta -analysis. Results: A total of 14 studies met the inclusion criteria. Overall, acute symptomatic seizures were observed in 20.5% (95% con fidence interval [CI] 13.7%-30.7%, I-2 =60.6%) patients with MOG-Ab-associated disease, and in a similar proportion of children respectively (20.0%; 95% CI 14.3%-27.8%, I-2 =7.0%). The pooled probability of seizure occurrence in males was 30.1% (95% CI 17.5%-52%, I-2 =0.0%) while that in females was much lower (12.0%; 95% CI 5.5%-26.4%, I-2 =0.0%). Furthermore, when we focused on those with acute disseminated en- cephalomyelitis -like phenotype, 37.3% patients experienced seizures (95% CI 21.0%-66.3%, I-2 =55.8%). Conclusions: Our study suggested that epileptic seizures were common in MOG-Ab-associated disease and of- fered insight into associated factors that contribute to the occurrence of seizures. Future studies with explicit evaluation are required.