Neuromyelitis optica spectrum disorders: An experience from tertiary care hospital of North–West India

Abstract

Abstract Introduction N ew criteria given by International Panel for NMO Diagnosis (IPND) for Neuromyelitis optica (NMO) & widespread availability of neuroimaging and diagnostic facilities, have changed the concepts of NMOSD. Objectives To study the clinico- radiological profile of patients of NMOSDs & categorize them into specific groups according to current diagnostic criteria. Materials and Methods This was a prospective study of 54 cases of NMOSDs admitted to the Department of Neurology of SMS Medical College, Jaipur, Rajasthan,from August 2014 to March 2017. Results Of the 54 cases, Female to Male ratio was 3.8:1 and mean age of the study population was 34.1 years. NMOSD with AQP4-IgG group constituted 42.5%(n = 23), NMOSD without AQP4-IgG group constituted 35.2% (n = 19), NMOSD with unknown AQP4-IgG status group constituted 22.2% (n = 12). Most common clinical presentation was myelitis (70.3%) followed by optic neuritis (48.12%), area postrema syndrome (29.6%), brainstem syndrome (24.07%), cerebral syndrome (9.25%) and diencephalic syndrome (1.8%). MRI brain & spine were abnormal in respectively 41.1% & 71.7% cases. Conclusion Revised diagnostic criteria for NMOSD enables them to diagnose early & classify even in absence of AQP4-IgG positivity. They have varied clinical presentation and neuro-imaging plays an important diagnostic role in defining these syndromes.