The magnetic resonance imaging (MRI) of brain and cervical spine findings, at time of diagnosis of neuromyelitis optica spectrum disorder patients in Isfahan city

Abstract

Neuromyelitis optica spectrum disease is a demyelinating disease which mainly involves optic nerve and spinal cord. Most of patients have abnormal brain MRI.The point is involvement of regions with high expression of aquaporin 4 channels. Long extending transverse myelitis (LETM) in cervical region is one of the main signs for NMOSD diagnosis. This is a retrograde study on 105 patients with neuromyelitis optica spectrum disease diagnosis, referred to Isfahan Kashani Hospital MS clinic. Patient's age, age of onset, presenting symptom ,primary brain and cervical MRI findings and Expanded Disability Status Scale(EDSS) recorded. Anti-AQP4 antibody was checked with cell based culturing method in a unique laboratory. 105 cases of NMOSD including 80(76.19%) females and 25(23.81%) males with mean age of onset of 28±12 were recorded. 32(30.47 %) patients were.LETM and segmental spinal lesions were found in 48(45.71%) and 28(26.66%) of all. Diagnostic brain lesions(Including Area postreoma ,brain stem ,thalamus ,hypothalamus, periepandymal area of 3rd and 4th ventricle)and posterior periventricular lesions were seen in 34(32.38%) and 44(41.90%) of them.Also posterior periventricular lesions were present in 16 seropositive and segmental spine lesion were found in 9 (28.12%) of them.49.52% of all patients presented with optic neuritis at the first time and 39.04% referred with myelitis. We found lesions in posterior periventricular region and segmental type myelitis.These lesions did not mentioned in the NMOSD diagnosis criteriayet. Another point is occurrence of vertigo and ataxia in 11 patients as first presentations of the disease which show lesions in regions with high expression of aquaporin 4 channels.