[Neuroradiological aspects of Devic's neuromyelitis optica].
BACKGROUND
Neuromyelitis optica (NMO) is a rare inflammatory and demyelinating disorder of the central nervous system, restricted to optical nerves and spinal cord. The main neuroradiological aspects, now summarized into a complete set of diagnosis criteria, are a normal cerebral MRI at onset and longitudinal involvement of the spinal cord concerning more than 3 vertebral segments. The clinical course and frequency of typical lesions remain unknown.


OBJECTIVE
We here report neuroradiological data from patients suffering from NMO.


METHODS
Brain and spinal cord MRI were systematically reviewed for 32 afro-Caribbean patients.


RESULTS
A typical longitudinal spinal lesion was seen in 44.7 percent with or without edema; a lesion involving less than 3 vertebral segments in 26.3 percent and no lesion in 21.1 percent. Longitudinal study of a few bouts suggested a progressive normalisation of spinal cord appearance. Atrophy was negatively correlated with immunosuppressive treatment. Cerebral lesions usually absent at onset were correlated to the follow-up. In a non-recursive condition, patients completed diagnostic criteria for encephalic and spinal lesions in 82.8 percent and 48.1 percent.


CONCLUSIONS
Radiology of spinal bouts showed multiple aspects besides the typical form. The notion of multiple bouts must be added to the spinal criteria to achieve good sensitivity. A typical extensive spinal lesion is usual in the follow-up, but seen after less then half of the bouts. Requiring such a lesion would delay the diagnosis.
Bonnan
M
M
Service de Neurologie, Centre Hospitalier Universitaire de Fort-de-France, Hôpital Pierre Zobda Quitman, BP 632, 97261 Fort-de-France Cedex. mickael.bonnan@caramail.com
Olindo
S
S
Signate
A
A
Khaddam
S
S
Caparros-Lefebvre
D
D
Smadja
D
D
Cabre
P
P
D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D009471:Neuromyelitis Optica / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D009483:Neuropsychological Tests; D009900:Optic Nerve / Q000276:immunology / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology*; D013223:Statistics as Topic; D013595:Syringomyelia / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D016896:Treatment Outcome
D007166:Immunosuppressive Agents