Conus involvement and leptomeningeal enhancement in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder: A case report
| Autor: | Nancy N. Hu, Cory J Myers, Benjamin Osborne, Amy Li Safadi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pathology
medicine.medical_specialty Flaccid paralysis Myelin oligodendrocyte glycoprotein 03 medical and health sciences 0302 clinical medicine Neuroimaging Conus medicine Spectrum disorder 030212 general & internal medicine Neuromyelitis optica biology business.industry Multiple sclerosis General Medicine medicine.disease biology.organism_classification Conus medullaris medicine.anatomical_structure Neurology biology.protein Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Multiple Sclerosis and Related Disorders. 52:103011 |
| ISSN: | 2211-0348 |
| DOI: | 10.1016/j.msard.2021.103011 |
| Popis: | There are a variety of clinical phenotypes and radiological features that continue to make a diagnosis of neuromyelitis optica spectrum disorder (NMOSD) challenging. We present an atypical case of an adult woman who presented with flaccid paralysis of all extremities with unusual neuroimaging features, including extensive enhancing lesions in the upper cervical cord and conus medullaris with associated leptomeningeal enhancement. She was ultimately found to have AQP4 antibody-positive NMOSD. We discuss the factors that complicated a timely diagnosis, including her atypical radiographic features and an initially negative cell-based assay for myelin oligodendrocyte glycoprotein (MOG) and aquaporin-4 (AQP4) antibodies. Despite the rarity of conus medullaris involvement or leptomeningeal enhancement in AQP4 antibody-positive NMOSD, it is important to maintain a high level of clinical suspicion to avoid diagnostic and therapeutic delays. Though cell-based assays have high sensitivities, testing should be repeated on negative values in these scenarios. |
| Databáze: | OpenAIRE |
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