Devic's neuromyelitis optica: clinical, laboratory, MRI and outcome profile

Devic's neuromyelitis optica (NMO) associates optic neuritis and myelitis without any other neurological signs. Many patients with NMO may be diagnosed as having multiple sclerosis (MS), optic neuritis and myelitis being the inaugural symptom in 20% and 5% of MS cases, respectively. The aim of...

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Bibliographic Details
Published in:Journal of the neurological sciences 2002-05, Vol.197 (1), p.57-61
Main Authors: de Seze, J., Stojkovic, T., Ferriby, D., Gauvrit, J.-Y., Montagne, C., Mounier-Vehier, F., Verier, A., Pruvo, J.-P., Hache, J.-C., Vermersch, P.
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Biological and medical sciences
Central Nervous System - pathology
Child
Cohort Studies
CSF
Devic's syndrome
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
MRI
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Myelitis
Neurology
Neuromyelitis optica
Neuromyelitis Optica - drug therapy
Neuromyelitis Optica - pathology
Optic neuritis
Retrospective Studies
Treatment Outcome
Vasculitis
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Summary:Devic's neuromyelitis optica (NMO) associates optic neuritis and myelitis without any other neurological signs. Many patients with NMO may be diagnosed as having multiple sclerosis (MS), optic neuritis and myelitis being the inaugural symptom in 20% and 5% of MS cases, respectively. The aim of our study was to compare a new NMO cohort with recent studies and to try to determine the place of NMO in the spectrum of MS. We retrospectively studied 13 patients with a complete diagnostic workup for NMO. We compared our data with the most recent studies on NMO and with the criteria proposed by Wingerchuck et al. [Neurology 53 (1999) 1107]. We also determined whether these patients fulfilled the diagnostic criteria for MS. Thirteen patients (10 women and three men, with a mean age of 37.4 years) were included in the study. We found similar results to previously published data, except for an association with vasculitis in 38% of our cases. All but three of the patients fulfilled the clinical criteria for MS and two patients fulfilled both clinical and MRI criteria for MS. However, if we applied more restrictive criteria concerning spinal cord and brain MRI and CSF, none of our NMO patients fulfilled the MS diagnostic criteria. NMO might therefore be differentiated from MS by the application of more stringent criteria. Furthermore, all NMO patients should be investigated for vasculitis, even those with no history of systemic disease.
ISSN:0022-510X
1878-5883
DOI:10.1016/S0022-510X(02)00043-6