Neuromyelitis optica syndrome disorder a case study / Ralph Justin N. Peralta.

Includes bibliographical references.

Abstract: Neuromyelitis optica spectrum disorder (NMOSD), also called Devic's disease, is a severe demyelinating inflammatory disease (Barnett Y. et al, 2014). This is an autoimmune process affecting the central nervous system. It affects the myelin sheath, specifically the ones surrounding the spinal cord and optic nerves causing paralysis and blindness. It was previously considered a variant of Multiple Sclerosis (MS) due to similarities in its clinical presentation. However, research suggested that NMOSD was a distinct and distinguishable disease. This study reviews a case of a 41-year-old male who was admitted due to persistent right parietal headache, generalized body weakness, eye pain and vision loss. Physical examination revealed left homonymous hemianopsia. CT scan was done showing an appearance of ischemic infarct or nonspecific edema with follow-up MRI now considering a CNS Lymphoma vs Glioma in the right parieto occipital lobe. After a few days MR spectroscopy was done favoring a non-neoplactic process and more of an inflammatory demyelinating disease such as neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). Additional Oligoclonal panel diagnostic test which is more specific for MS was done showing a negative result. Patient was started on methylprednisolone with eventual improvement in symptoms and was subsequently discharged. Imaging modalities such as CT scan and MRI are essential in the diagnosis of NMOSD. However, other brain lesions may mimic its symptoms such as Multiple Sclerosis and CNS lymphoma and may appear similar in CT scan or MRI. Hence, the use of advanced imaging modalities such as MR Spectroscopy as well as laboratory examinations such as Oligoclonal Panel may prove useful in differentiating between them.

Research - Department of Radiology