JA Clinical Reports · Published 2025-11-05 · DOI 10.1186/s40981-025-00829-1
Abstract 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.
Abstract from DOAJ. Public domain (CC0 1.0).
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