Neuromyelitis Optica and Neuromyelitis Optica Spectrum Disorders : Report of Nine Cases

Abstract

Objective: We aimed to report our nine Neuromyelitis Optica (NMO) and NMO Spectrum Disorders (NMOSD) cases which have different presentations. Patients and Methods: In this observational retrospective study, conducted between September 2011 and September 2015 in Antalya Education and Research Hospital Neurology Department, we enrolled 9 patients who were diagnosed as NMO/NMOSD. Results: We had 9 patients (8 female, 1 male). The mean age at onset was 49 years (36-67). While 7 patients were diagnosed with NMO, 2 patients’ diagnoses were NMOSD. The Case 6 was admitted to our clinic with an LETM (longitudinally extensive transverse myelitis) attack after 4 months of chemotherapy and radiotherapy treatment for gallbladder adenocancer. The Case 8 experienced LETM after the diagnosis of pulmonary tuberculosis and under anti-tuberculosis treatment, and the Case 9 was presented with LETM after post-vaccination. Optic nerve and spinal cord involvement occurred simultaneously in three patients. In three cases, optic neuritis developed 4 months, 15 months and 5 years after the myelitis attack. The Case 7 was referred to the hospital owing to cranial involvement, following a history of optic neuritis attacks six months earlier. The Case 1 had three recurrent optic neuritis attacks before the last attack of admission which included brain stem involvement and LETM. The Case 4 was receiving low dose interferone beta-1a with diagnosis of MS. NMO-IgG seropositivity was detected in 6 patients. Conclusion: Most of our patients were female and have relapsing course. Patients who experienced relapses, mostly were seropositive for NMO- IgG.