Introduction FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES) is a rare form of MOG-associated disease (MOGAD) first introduced by Ogawa et al.1 It is characterised by an encephalitis-like onset with seizure, headache and cortical symptoms with a unique radiological pattern of cortical swelling, mostly unilateral, sometimes associated with leptomeningeal enhancement. We present here a 1-year course of FLAMES with the typical migratory pattern from the initially unilateral cortical FLAIR hypersignal to complete disappearance of inflammatory lesions.
Patient A young adult patient with no prior medical history was admitted for new-onset of focal myoclonus of the left hand with secondary generalised tonic-clonic seizures, headaches and fever. Brain MRI showed cortical swelling of the right central sulcus with leptomeningeal enhancement (figure 1A). The lumbar puncture revealed 104 white cell 13/ml with 84% polynuclear, normal glucose level and protein content without oligoclonal IgG bands....]]>