Knowledge on the clinical and radiological phenotype of myelin oligodendrocyte glycoprotein (MOG)–related disorders has been growing. We report the case of a patient who presented with subacute onset myelitis after an upper respiratory tract infection with normal cord imaging at onset and follow-up after 4 months (absence of lesions and atrophy), high-titer positive MOG-IgG, and a broad workup excluding other etiologies. The full clinical and radiological spectrum of MOG-related disorders is yet to be completely understood. Testing for MOG-IgG using cell-based assays should be considered in imaging-negative myelitis particularly if initial testing is non-revealing.
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