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Mult Scler Relat Disord ; 10: 22-25, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27919493

RESUMEN

It is difficult to predict whether a particular attack of neuromyelitis optica spectrum disorder (NMOSD) will affect the optic nerve [optic neuritis (ON): unilateral or bilateral], spinal cord (myelitis), brain or brainstem, or a combination of the above. We report an interesting case of recurrent ON of the same eye for a total of 11 episodes in a Chinese woman. Over a period of 22 years, the attacks only involved the left eye, and never the right eye and also no myelitis. For a prolonged duration, she was diagnosed as recurrent idiopathic ON. Only until she was tested positive for aquaporin 4 antibody that her diagnosis was revised to NMOSD. Optical coherence tomography revealed thinning of the retinal nerve fibre layer (RNFL) for the affected left eye, while the RNFL thickness was within normal range for the unaffected right eye. The disability accrual in NMOSD is generally considered to be attack-related - without a clinical attack of ON, there shall be no visual impairment, and no significant subclinical thinning of RNFL. Our case is in agreement with this notion. This is in contrast to multiple sclerosis where subclinical RNFL thinning does occur. This case highlights the importance of revisiting and questioning a diagnosis of recurrent idiopathic ON particularly when new diagnostic tools are available.


Asunto(s)
Ojo/fisiopatología , Neuromielitis Óptica/fisiopatología , Acuaporina 4/inmunología , Autoanticuerpos/sangre , Diagnóstico Diferencial , Potenciales Evocados Visuales , Ojo/diagnóstico por imagen , Femenino , Lateralidad Funcional , Humanos , Persona de Mediana Edad , Neuromielitis Óptica/diagnóstico por imagen , Neuromielitis Óptica/tratamiento farmacológico , Recurrencia , Tomografía de Coherencia Óptica
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