title: [Neuromyelitis optica spectrum disorder: a case report].
abstract: Neuromyelitis optica (NMO) is a relapsing inflammatory disease of the central nervous system, usually affecting the optic nerves and the spinal cord. It is presumed to be an antibody-mediated disorder and the target antigen is the water channel aquaporin-4 (AQP4) on astrocyte cell membranes. NMO is a disease caused by astrocyte disorder and is distinct from multiple sclerosis (MS), which is a primarily demyelinating disease caused by oligodendrocyte disorder. In NMO, spinal MRI shows a T2-hyperintense, longitudinally extensive (≥ 3 vertebral segments) spinal cord lesion. The case, which has optic neuritis or transverse myelitis with the presence of AQP4 antibody, is called as NMO spectrum disorder. A 68 year-old woman with a history of hypertension and diabetes mellitus was brought to the former hospital by ambulance with acute onset of tetraparesis. She denied visual acuity disturbance. MRI revealed a T2-hyperintense lesion from C5 to T2 level. Laboratory examination showed the presence of AQP4 antibody and the absence of oligoclonal bands. Low-dose steroid treatment was started after establishing a diagnosis of NMO. She incompletely recovered from disability, although the T2-hyperintense lesion on MRI had almost disappeared six months after the onset. It is important to maintain a high index of suspicion for NMO in cases with a longitudinally extensive spinal cord lesion, because untreated NMO leads to severe disability.
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Japan.
authors.forename: Tetsuryu
authors.initials: T
authors.lastname: Mitsuyama
authors.forename: Taku
authors.initials: T
authors.lastname: Yoneyama
authors.forename: Sakiko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Mizuo
authors.initials: M
authors.lastname: Kagawa
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
mesh_terms: D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000032:analysis*; D001327:Autoimmune Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009471:Neuromyelitis Optica / Q000175:diagnosis*
chemical_list: D051401:Aquaporin 4; D001323:Autoantibodies