MOG-Antibody-Associated Hypertrophic Pachymeningitis With Intracranial Hypertension: A Case Report

Background:​The clinical spectrum of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) continues to expand. Hypertrophic pachymeningitis (HP) represents a rare and severe neurological manifestation.Objective:​To describe a case of MOGAD-associated HP driving intracranial hypertension (IH) via venous sinus compression.Methods:​Case study.Results:​A 28-year-old male presented with headache, binocular diplopia, and tinnitus.Examination revealed bilateral papilledema and elevated intracranial pressure(330 mmH₂O). MOG-IgG was positive in serum and CSF. Brain MRI demonstrated diffuse dural enhancement and right transverse sinus stenosis. The patient showed significant improvement after treatment with corticosteroids and mycophenolate mofetil.Conclusions:​HP is a novel MOGAD phenotype that can cause IH via venous compression. MOG antibody testing is recommended in idiopathic HP cases with IH signs to guide immunomodulatory therapy.