title: Neuromyelitis optica preceded by brain demyelinating episode.
abstract: Neuromyelitis optica (NMO) is considered a distinct disease from multiple sclerosis (MS) because of its pathogenesis. It is well accepted that NMO selectively affects the spinal cord and optic nerve and is not associated with brain lesions at the onset of the disease, unlike MS. We present a unique case where the patient's initial lesion was in the brain, and optic neuritis and myelitis were revealed 6 years after the brain lesion. In addition, the patient's serum antiaquaporin 4 (AQP4) antibody was positive. We consider the brain lesion to precede abnormal lesion of NMO, and the AQP4 measurement is important for diagnostics, even if it occurs with brain lesions.
authors.affiliation: Division of Neurology, Internal Medicine, Nippon Medical School, Tokyo, Japan. amemiya@nms.ac.jp
authors.forename: Shimon
authors.initials: S
authors.lastname: Amemiya
authors.forename: Makoto
authors.initials: M
authors.lastname: Hamamoto
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kumagai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ueda
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Katayama
authors.forename: Keiko
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D051401:Aquaporin 4 / Q000097:blood; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000150:complications* / Q000473:pathology; D003711:Demyelinating Diseases / Q000150:complications* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009471:Neuromyelitis Optica / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D013116:Spinal Cord / Q000473:pathology; D013997:Time Factors; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4