Neuromyelitis Optica Spectrum Disorder: A Case Report

Abstract

Background Neuromyelitis optica spectrum disorder is an autoimmune, astrocytopathic CNS disease, mainly involving the optic nerves, spinal cord, and brain stem regions. The “International Panel for NMOSD Diagnosis (IPND) Diagnostic Criteria” was implemented to define the disorder. Case Presentation A 38-year-old patient presented with visual loss of eight months' duration and weakness of the lower extremities of one week's duration. The patient had bilateral optic atrophy on fundoscopic examination, and flaccid paraplegia with sensory loss below T4 level. Serological tests for syphilis, HIV infection, and SLE were negative. Aquaporin-4 antibody test was not done due to limited clinical setup. T2-spine MRI revealed long central thoracic segment (T3 to T6) hyperintense lesion with mild cord expansion. Long segment central canal dilation (syrinx) was noted in the cord proximal to the lesion. Diagnosis of opticospinal variant, NMOSD was made using IPND diagnostic criteria. The patient was started on dexamethasone 50 mg, IV, four times daily (QID) for one week, and changed to prednisolone 1 mg/kg (40 mg) PO daily for one month, to be tapered over three-to-six months. The patient was scheduled to initiate azathioprine 50 mg PO twice daily. Conclusion The case emphasizes the existence of neuromyelitis optica spectrum disorder in clinical settings of the developing world. High index of suspicion of this rare disease is required to avoid delayed diagnosis and treatment.

Neuromyelitis Optica Spectrum Disorder (Nmosd): A Rare Report

“…In this report, the patient was administered rituximab as a drug of choice, which was different from the case report in which azathioprine was used as the treatment option, reported by [6].…”

“…Following granulocyte infiltration, oligodendrocyte destruction and demyelination occur. In contrast to MS, the demyelination found in NMOSD is a secondary event that results from primary astrocyte injury [6]. In NMOSD, clinical syndromes like bilateral optic neuritis, longitudinally extensive transverse myelitis, region postrema syndrome, acute brain stem syndrome, diencephalic syndrome, and symptomatic cerebral syndrome were seen.…”

Жаңы Аныкталган Клиникалык Учур Оптиконевромиелит (Девик Оорусу)

“…Сывороточный AQP4-IgG выявляется у 80% пациентов с оптиконейромиелитом. Половина AQP4-IgG-отрицательных результатов у пациентов с клиническими и нейровизуализационными признаками оптиконейромиелита имеют отношение к категории пациентов с антителами к миелин-олигодендроцитарному гликопротеину (MOG) [7] в случаях с отрицательными результатами на оба вида белка еще предстоит объяснить. Эпидемиологическая картина оптиконейромиелита характеризуется пиком встречаемости среди взрослых лиц среднего возраста и среди лиц небелой расы [8].…”

Neurology Training and Medical Education in Resource-Limited Settings: Building and Growing the First Neurology Residency Program in East Africa

“…Between 2021 and 2023, a total of 61 manuscripts were authored by our alumni, including 27 original research articles, 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 16 case reports, 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 2 perspective pieces, 50 51 3 review articles, 52 53 54 1 book chapter, 55 1 association statement, 56 1 consensus statement, 57 1 data note, 58 and 8 that were published on a preprint server (not peer reviewed). 59 60 61 62 63 64 65 Of these academic contributions, 19 of these papers were published in journals with an impact factor of 3.0 to 10.0.…”