Abstract

Neuromyelitis optica spectrum disorders (NMOSDs) are rare, with estimated prevalence rates between 0.5 and 4.4/100,000 population. NMOSDs are mediated by IgG antibodies against the water channel protein aquaporin-4 (AQP4-IgG) and typically present with optic neuropathy and transverse myelitis. Patients may also develop nausea and vomiting because the area postrema, which contains the chemosensitive nausea and vomiting center, is rich in aquaporin-4 and may be affected in NMOSDs. In fact, isolated intractable nausea and vomiting may be the initial presentation of NMOSDs.

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