Clinical and radiological features of MS, NMOSD, and MOGAD, and evolution of the diagnostic processes in Thailand

The prevalence and clinical features of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) are similar in the Thai population to those of other Asian countries. These disorders share common features and mimic other conditions, emphasizing the importance of helpful diagnostic tools, including serologic testing and imaging study. Since the establishment of the first laboratory center in Thailand for aquaporin‐4 antibody (AQP4‐Ab) in 2010, seven centers nationwide have provided testing and increased the diagnostic rate in the past decade. The Thai Clinical Practice Guideline for MS and NMOSD was published in 2018, incorporating AQP4‐Ab testing and magnetic resonance imaging of the brain in all patients suspected of demyelinating diseases. Herein, we summarize the evolution of processes and obstacles in the diagnosis of demyelinating diseases in Thailand.