title: Neuromyelitis optica spectrum disorders with multiple brainstem manifestations: a case report.
abstract: BACKGROUND
  Multiple brainstem manifestations have been rarely reported during the same attack in neuromyelitis optica spectrum disorders (NMOSD).
  
  
  METHODS
  We describe a 39-year-old Asian woman presenting multiple brainstem manifestations including intractable nausea and vomiting, vertigo, diplopia, facial palsy, hypogeusia, ophthalmoplegia, hemiplegia, dysphagia and tonic spasm during the same attack. Hypogeusia was transient and recovered without any immunotherapy. The brain MRIs showed progressive multiple lesions in the brainstem. NMO-IgG (aquaporin4-antibody, AQP4-Ab) were positive in both serum and cerebral spinal fluid. The symptoms and signs were controlled after immunosuppressive therapy. No relapse happened during the 15-month follow-up.
  
  
  CONCLUSIONS
  This report emphasizes multiple brainstem manifestations during the same attack in NMOSD and the most characteristic symptom was reversible hypogeusia.
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
authors.forename: Mingxia
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
authors.forename: Chunlai
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
authors.forename: Shuhui
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China. jimeili2002@163.com.
authors.forename: Jimei
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China.
authors.forename: Ruijin
authors.initials: R
authors.lastname: Wang
mesh_terms: D000328:Adult; D001933:Brain Stem / Q000473:pathology*; D005260:Female; D006801:Humans; D009471:Neuromyelitis Optica / Q000150:complications* / Q000473:pathology*
keywords: Multiple brainstem manifestations; Neuromyelitis optica spectrum disorders; Transient hypogeusia
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