A case report on bilateral neuromyelitis optica

Authors

  • Abhishek Mansinh Patel Department of Ophthalmology, SMIMER Medical College, Surat, Gujarat, India
  • Khushnood M. Sheikh Department of Ophthalmology, SMIMER Medical College, Surat, Gujarat, India
  • Manisha B. Shastri Department of Ophthalmology, SMIMER Medical College, Surat, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20164239

Keywords:

Acute myelitis, Aquaporin-4, Demyelination, Devic disease, Neuromyelitis optica, Optic neuritis

Abstract

Neuromyelitis optica (NMO, Devic disease) is an autoimmune inflammatory disorder of the central nervous system (CNS) in which the autoimmune system attacks myelin of the neurons located at the optic nerve and spinal cord, thus producing a simultaneously or sequential longitudinally extensive inflammation of the optic nerve (optic Neuritis) and spinal cord (myelitis). Early discrimination between NMO and multiple sclerosis is important because the two diseases have different natural histories and treatment regimens. Seropositivity for NMO-IgG and longitudinally extensive spinal cord lesions are characteristic of NMO. Despite the absence of a definitive therapeutic strategy for NMO syndrome, methylprednisolone pulse therapy is recommended in the acute phase. Treatment strategies in relapse phases are aimed at preventing relapses, and increasing evidence shows a better clinical response of immunosuppressive therapy than immuno-modulating therapy (a standard multiple sclerosis-modulating therapy). We have described a 32 years old girl who had visual loss due to acute optic neuritis before 15 days in right eye and followed by complete visual loss in left eye. NMO was diagnosed because of its characteristic longitudinal myelitis and positive NMO-IgG. After combine therapy with prednisolone and an immunosuppressant, the patient’s medical condition was stable and no relapse symptoms were observed.

References

Argyriou AA, Makris N. Neuromyelitis optica: a distinct demyelinating disease of the central nervous system. Acta Neurol Scand. 2008;118(4):209-17.

Walsh & Hoyt: Neuromyelitis Optica (Devic's Disease). Available at: https://sites.google.com/ site/ neuroophthalmologyfellowship/ home/ afferent-visual-system/ neuromyelitis-optica.

Nightingale H, Witherick J, Wilkins A. Diagnosis of longitudinally extensive transverse myelitis. BMJ Case Rep. 2011;2011:bcr1020103444.

Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG. Revised diagnostic criteria for neuromyelitis optica. Neurology. 2006;66(10):1485-9.

Wingerchuk DM, Weinshenker BG. Neuromyelitis optica. Curr Treat Options Neurol. 2008;10(1):55-66.

Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. Lancet Neurol. 2007;6(9):805-15.

Wingerchuk DM. Diagnosis and treatment of neuromyelitis optica. Neurologist. 2007;13(1):2-11.

Downloads

Published

2016-12-16

How to Cite

Patel, A. M., Sheikh, K. M., & Shastri, M. B. (2016). A case report on bilateral neuromyelitis optica. International Journal of Research in Medical Sciences, 4(12), 5497–5500. https://doi.org/10.18203/2320-6012.ijrms20164239

Issue

Section

Case Reports