A case of cerebral aquaporinopathy.
A 35-year-old woman was hospitalized due to impaired consciousness. Magnetic resonance imaging (MRI) revealed multiple parenchymal lesions in supra and infratentorial brain regions, which were considered responsible for her declining consciousness level. She was treated with intravenous methylprednisolone. Neurological symptoms improved and she was discharged. She was readmitted 14 months later due to intractable hiccups. A follow-up brain MRI revealed an abnormal signal near the area postrema in the dorsal medulla. Serum aquaporin-4 antibody levels were positive, but there were no visual manifestations or myelitis. Spinal MRI was negative for longitudinally extended transverse myelitis throughout the clinical course.
Tanaka
A
A
Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan. tnk-a@koto.kpu-m.ac.jp
Yoshida
T
T
Yamada
T
T
Isayama
R
R
Fujiwara
Y
Y
Shiga
K
K
Yamada
K
K
Tanaka
K
K
Nakagawa
M
M
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000906:Antibodies / Q000032:analysis; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D051401:Aquaporin 4 / Q000276:immunology*; D031608:Area Postrema / Q000473:pathology; D001921:Brain / Q000473:pathology; D005260:Female; D006606:Hiccup / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008526:Medulla Oblongata / Q000473:pathology; D008775:Methylprednisolone / Q000627:therapeutic use; D009188:Myelitis, Transverse / Q000276:immunology / Q000473:pathology; D053146:Myeloblastin / Q000032:analysis / Q000276:immunology; D009460:Neurologic Examination; D009471:Neuromyelitis Optica / Q000473:pathology*; D009195:Peroxidase / Q000032:analysis / Q000276:immunology; D012008:Recurrence; D013116:Spinal Cord / Q000473:pathology
D000893:Anti-Inflammatory Agents; D000906:Antibodies; D019268:Antibodies, Antineutrophil Cytoplasmic; D051401:Aquaporin 4; D009195:Peroxidase; D053146:Myeloblastin; D008775:Methylprednisolone