Magnetic resonance imaging characteristics and clinical manifestations of brain abnormalities in neuromyelitis optica

Abstract

Objective To summarize the magnetic resonance imaging (MRI) characteristics and clinical manifestations of brain abnormalities in patients with neuromyelitis optica (NMO). Methods The clinical and brain MRI data of 19 patients with NMO treated in our hospital from January, 2002 to May, 2008 were retrospectively analyzed. Results Of the 19 patients with NMO, 15 underwent brain MRI, and brain abnormalities were identified in 7 patients. The lesions involved the cerebral hemisphere in 3 cases, the thalamus in 2 cases, the hypothalamus in 1 case, the surrounding areas of the third ventricle and the midbrain aqueduct in 1 case, the midbrain in 1 case, the pons in 1 case, and the medulla in 2 cases. On brain MRI, the lesions appeared as spots, patches or linear changes in the brain with low signals on T1-weighted imaging and high signals on T2-weighted and FLAIR imaging. The main clinical manifestations included nausea, vomiting, hiccup, diplopia, nystagmus, facial numbness, cognition impairment, and lethargy. Conclusion NMO may cause lesions in different brain regions, typically in the surrounding areas of the ependyma and hypothalamus. Clinical manifestations may occur in some patients with brain lesions, and in a few cases, these manifestations can be the initial clinical event of NMO onset. Key words: Neuromyelitis optica; Brain abnormalities; Magnetic resonance imaging; Clinical manifestation