OBJECTIVES: To evaluate the spectrum of neuromyelitis optica (NMO), including characteristics of the index events (optic neuritis [ON]) and myelitis), neuroimaging, CSF, and serologic studies, and to evaluate the long-term course. METHODS: Review of 71 patients with NMO evaluated at the Mayo Clinic between 1950 and 1997. RESULTS: NMO was either monophasic or relapsing. Patients with a monophasic course (n = 23) usually presented with rapidly sequential index events (median 5 days) with moderate recovery. Most with a relapsing course (n = 48) had an extended interval between index events (median 166 days) followed within 3 years by clusters of severe relapses isolated to the optic nerves and spinal cord. Most relapsing patients developed severe disability in a stepwise manner, and one-third died because of respiratory failure. Features of NMO distinct from "typical" MS included >50 cells/mm3 in CSF (often polymorphonuclear), normal initial brain MRI, and lesions extending over three or more vertebral segments on spinal cord MRI. CONCLUSIONS: Clinical, laboratory, and imaging features generally distinguish neuromyelitis optica from MS. Patients with relapsing optic neuritis and myelitis may have neuromyelitis optica rather than MS. Patients with a relapsing course of neuromyelitis optica have a poor prognosis and frequently develop respiratory failure during attacks of cervical myelitis.
OBJECTIVES: To evaluate the spectrum of neuromyelitis optica (NMO), including characteristics of the index events (optic neuritis [ON]) and myelitis), neuroimaging, CSF, and serologic studies, and to evaluate the long-term course. METHODS: Review of 71 patients with NMO evaluated at the Mayo Clinic between 1950 and 1997. RESULTS: NMO was either monophasic or relapsing. Patients with a monophasic course (n = 23) usually presented with rapidly sequential index events (median 5 days) with moderate recovery. Most with a relapsing course (n = 48) had an extended interval between index events (median 166 days) followed within 3 years by clusters of severe relapses isolated to the optic nerves and spinal cord. Most relapsing patients developed severe disability in a stepwise manner, and one-third died because of respiratory failure. Features of NMO distinct from "typical" MS included >50 cells/mm3 in CSF (often polymorphonuclear), normal initial brain MRI, and lesions extending over three or more vertebral segments on spinal cord MRI. CONCLUSIONS: Clinical, laboratory, and imaging features generally distinguish neuromyelitis optica from MS. Patients with relapsing optic neuritis and myelitis may have neuromyelitis optica rather than MS. Patients with a relapsing course of neuromyelitis optica have a poor prognosis and frequently develop respiratory failure during attacks of cervical myelitis.
Authors: Amy M L Quek; Andrew McKeon; Vanda A Lennon; Jayawant N Mandrekar; Raffaele Iorio; Yujuan Jiao; Chiara Costanzi; Brian G Weinshenker; Dean M Wingerchuk; Claudia F Lucchinetti; Elizabeth A Shuster; Sean J Pittock Journal: Arch Neurol Date: 2012-08
Authors: R M Papais-Alvarenga; C M Miranda-Santos; M Puccioni-Sohler; A M V de Almeida; S Oliveira; C A Basilio De Oliveira; H Alvarenga; C M Poser Journal: J Neurol Neurosurg Psychiatry Date: 2002-10 Impact factor: 10.154
Authors: Elizabeth Cotzomi; Panos Stathopoulos; Casey S Lee; Alanna M Ritchie; John N Soltys; Fabien R Delmotte; Tyler Oe; Joel Sng; Ruoyi Jiang; Anthony K Ma; Jason A Vander Heiden; Steven H Kleinstein; Michael Levy; Jeffrey L Bennett; Eric Meffre; Kevin C O'Connor Journal: Brain Date: 2019-06-01 Impact factor: 13.501