Teaching neuroimages: neuromyelitis optica misdiagnosed as spinal cord tumor.
A 17-year-old girl presented with acute-onset cervical pain, followed by left arm weakness and gait disturbances. Spinal cord astrocytoma was diagnosed by MRI performed at an outpatient facility (figure, A and B). The patient was admitted to the neurosurgery department to undergo spinal cord biopsy. A second neurologic evaluation indicated neuromyelitis optica (NMO) as the most likely diagnosis, which was confirmed by NMO-immunoglobulin G seropositivity. The patient was treated with rescue plasmapheresis with substantial clinical and radiologic (figure, C) improvement.
From the Second Department of Neurology (G.T., S.K., A.B., L.S., K.V.) and Second Department of Neurosurgery (E.B.), University of Athens, School of Medicine, "Attikon" University Hospital, Greece; and the International Clinical Research Center (G.T.), St. Anne's University Hospital, Brno, Czech Republic.
Georgios
G
Tsivgoulis
Stefanos
S
Kontokostas
Efstathios
E
Boviatsis
Anastasios
A
Bonakis
Leonidas
L
Stefanis
Konstantinos
K
Voumvourakis
D000293:Adolescent; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009471:Neuromyelitis Optica / Q000175:diagnosis*; D013116:Spinal Cord / Q000473:pathology*; D013120:Spinal Cord Neoplasms / Q000503:physiopathology*