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neuromyelitis_optica_spectrum_disorder

Neuromyelitis optica spectrum disorder (NMOSD) is a rare, autoimmune disease of the central nervous system (CNS) that primarily attacks the optic nerves and spinal cord leading to blindness and paralysis


Neuropathic pain is a localized sensation of unpleasant discomfort caused by damage or disease that affects the somatosensory system.

It is a common and debilitating consequence of neuromyelitis optica spectrum disorder (NMOSD) myelitis, with no satisfactory treatment.


a 50-year-old caucasian man presenting with lumbar pain, bilateral ataxia, central facial palsy, ophthalmoparesis and urinary retention. Cerebral MRI hinted a hyperintensity of the medulla oblongata and cervical medulla suggestive of myelitis. Cerebrospinal fluid displayed lymphocytic pleocytosis and elevated protein concentration. Without the possibility to rule out an infectious or inflammatory aetiology, antibiotics and corticosteroids were started. Nevertheless, neurological status deteriorated with loss of muscle strength and left eye amaurosis. A neuroaxis MRI exhibited encephalomyelitis with signal abnormalities involving the pons, medulla oblongata, left optic nerve and cervicodorsal medulla. Although negative for aquaporin-4-IgG antibodies, the patient fulfilled criteria for seronegative neuromyelitis optica spectrum disorder with the presence of multiple core clinical characteristics. Through early institution of corticosteroids, plasma exchange and rituximab, good functional recovery was achieved (Expanded Disability Status Scale score of 2). However, left eye amaurosis persisted despite salvage therapy with intravenous immunoglobulin 1).

1)
Pires da Rosa G, Costa F, Guimarães J, Friões F. Seronegative neuromyelitis optica spectrum disorder: severe polysymptomatic presentation with successful treatment response. BMJ Case Rep. 2019 Mar 16;12(3). pii: e228553. doi: 10.1136/bcr-2018-228553. PubMed PMID: 30878968.
neuromyelitis_optica_spectrum_disorder.txt · Last modified: 2019/03/19 00:37 by administrador