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Background <p>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a demyelinating disorder that may relapse during pregnancy. The safety of neuraxial anesthesia in such patients remains unclear.</p> Case presentation <p>We describe a 32-year-old multiparous woman with MOGAD who developed intractable hiccups due to new medullary lesions at 35&#xa0;weeks of gestation. Despite steroid pulse therapy, symptoms persisted. At 36&#xa0;weeks and 2&#xa0;days, premature rupture of membranes occurred, and hiccups worsened with labor pain. After informed consent, labor epidural analgesia was initiated using low-concentration levobupivacaine with minimal fentanyl. Pain relief coincided with the reduction of hiccups. Vaginal delivery of a male infant was uneventful. Her hiccups resolved by postpartum day 4, and magnetic resonance imaging showed improvement in the lesion. She was discharged on postpartum day 7 without neurological worsening.</p> Conclusions <p>Labor epidural analgesia provided effective pain control and was associated with symptom relief in a parturient with active MOGAD.</p>

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Epidural labor analgesia in a pregnant woman with symptomatic recurrence of myelin oligodendrocyte glycoprotein antibody-associated disease: a case report

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  • 发表日期：

    2025年11月5日

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  • Satoshi Toyama,
  • Sooyeon Han

摘要

Background

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a demyelinating disorder that may relapse during pregnancy. The safety of neuraxial anesthesia in such patients remains unclear.

Case presentation

We describe a 32-year-old multiparous woman with MOGAD who developed intractable hiccups due to new medullary lesions at 35 weeks of gestation. Despite steroid pulse therapy, symptoms persisted. At 36 weeks and 2 days, premature rupture of membranes occurred, and hiccups worsened with labor pain. After informed consent, labor epidural analgesia was initiated using low-concentration levobupivacaine with minimal fentanyl. Pain relief coincided with the reduction of hiccups. Vaginal delivery of a male infant was uneventful. Her hiccups resolved by postpartum day 4, and magnetic resonance imaging showed improvement in the lesion. She was discharged on postpartum day 7 without neurological worsening.

Conclusions

Labor epidural analgesia provided effective pain control and was associated with symptom relief in a parturient with active MOGAD.