Refractory Trigeminal Neuralgia in MOGAD: Recognizing and Managing an Atypical Pain Phenotype

Myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) is a rare demyelinating condition typically presenting with optic neuritis, transverse myelitis, or brainstem involvement. However, cranial neuropathies, particularly trigeminal nerve, have been reported in a minority of cases and may manifest as facial numbness, allodynia, or neuropathic pain in the absence of classical MRI lesions of the nerve itself [1]. Our case highlights a patient with refractory craniofacial pain, scalp tingling, and bilateral blindness due to MOGAD.