Atypical Neuromyelitis Optica Spectrum Disorder With Diffuse Cerebral Abnormalities: A Case Report.
Braeden D NewtonOrhun KantarciDarin T OkudaPublished in: Journal of central nervous system disease (2020)
The recent expansion of the radiological criteria and the use of a highly specific biomarker, anti-aquaporin 4-IgG (AQP4 IgG), has significantly improved the ability of clinicians to provide a timely and accurate diagnosis for neuromyelitis optica spectrum disorder (NMOSD), especially when faced with an abnormal disease presentation. Here, we report on the 5-year clinical experience of a 69-year-old right-handed African American woman who initially presented following symptoms suggestive of transient global amnesia. Her clinical history was only remarkable for a single episode of visual decline with poor recovery experienced 35 years prior, with prior unrevealing serological investigations. Brain MRI features were significant for diffuse, bilateral white matter abnormalities throughout the supratentorial, deep gray matter, and infratentorial regions. Spinal cord imaging studies were within normal limits with no intramedullary high-signal abnormalities identified. Serological studies were significant for the presence of anti-aquaporin 4-IgG. The clinical features were supportive of the diagnosis of NMOSD. The data provided here highlight both the clinical and radiological heterogeneity of NMOSD.
Keyphrases
- spectrum disorder
- white matter
- african american
- spinal cord
- high resolution
- cerebral ischemia
- case report
- low grade
- magnetic resonance imaging
- multiple sclerosis
- spinal cord injury
- electronic health record
- subarachnoid hemorrhage
- contrast enhanced
- single cell
- computed tomography
- palliative care
- machine learning
- resting state
- neuropathic pain
- photodynamic therapy
- brain injury
- physical activity
- blood brain barrier
- artificial intelligence
- mass spectrometry
- high grade