scholarly journals Effect of Low Complement C4 on Clinical Characteristics of Patients with First-Episode Neuromyelitis Optica Spectrum Disorder

2021 ◽  
Vol Volume 17 ◽  
pp. 2859-2866
Author(s):  
Chunyang Pan ◽  
Yi Zhao ◽  
Haojie Xie ◽  
Yongyan Zhou ◽  
Ranran Duan ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Clinical Characteristics ◽  
Spectrum Disorder ◽  
First Episode ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Complement C4

A Girl With Back Pain, Paresthesias, and Painful Vision Loss

2021 ◽  
pp. 44-47
Author(s):  
Cecilia Zivelonghi ◽  
Andrew McKeon
Keyword(s):  
Back Pain ◽  
Neuromyelitis Optica ◽  
Immunoglobulin G ◽  
Vision Loss ◽  
Spectrum Disorder ◽  
Aquaporin 4 ◽  
Lower Limbs ◽  
First Episode ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Anti Cd20

A 12-year-old girl sought care for subacute onset of cramping back pain, along with paresthesias in her lower limbs up to the waistline, both hands, upper back, and chest, followed by rapidly progressive (over a few hours) painful vision loss affecting initially the right eye with subsequent involvement of the left eye. She underwent neuroophthalmologic evaluation and was diagnosed with bilateral optic neuritis. A positive Lhermitte sign was also present. The patient was tested for aquaporin-4-immunoglobulin G autoantibodies, which were positive in both serum and cerebrospinal fluid. A diagnosis of aquaporin-4-immunoglobulin G–positive neuromyelitis optica was made. The patient was treated with rituximab (anti-CD20 monoclonal antibody) and became episode-free, with no further accumulation of disability. The discovery of aquaporin-4-immunoglobulin G in 2004 has permitted the distinction of neuromyelitis optica spectrum disorder from other inflammatory central nervous system disorders. Aquaporin-4-immunoglobulin G represents a highly specific biomarker for neuromyelitis optica (almost 100% using molecular-based techniques), with sensitivity of approximately 80%. According to the most recent diagnostic criteria published in 2015, a diagnosis of neuromyelitis optica spectrum disorder can also be made for patients who are aquaporin-4-immunoglobulin G seronegative by any testing method, regardless of assay sensitivity, provided that more stringent clinical and radiologic requirements are met. Serial testing is recommended for these patients because late seroconversion has been described up to 4 years after the first episode.

Clinical characteristics of 153 Brazilian patients with neuromyelitis optica spectrum disorder (NMOSD)

2019 ◽  
Vol 27 ◽  
pp. 392-396 ◽  
Author(s):  
Yara Dadalti Fragoso ◽  
Nise Alessandra C. Sousa ◽  
Soniza Vieira Alves-Leon ◽  
Ronaldo Maciel Dias ◽  
Maria Lucia V. Pimentel ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Clinical Characteristics ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder

Diagnostic Challenges in Pediatric Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder

2017 ◽  
Vol 16 (03) ◽  
pp. 185-191
Author(s):  
Brenda Banwell ◽  
Anusha Yeshokumar
Keyword(s):  
Multiple Sclerosis ◽  
Neuromyelitis Optica ◽  
Spectrum Disorder ◽  
First Episode ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Pediatric Multiple Sclerosis ◽  
Mri Features ◽  
The Central Nervous System ◽  
Mog Antibodies ◽  
Magnetic Resonance Imaging Mri

AbstractThis review highlights the most common presentations of demyelination of the central nervous system (CNS, termed acquired demyelinating syndrome) in children, the difficulty in determining whether the first episode represents a monophasic/transient illness or relapsing disease, and the potential underlying etiologies that must be considered, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and disorders associated with antibodies to myelin oligodendrocyte glycoprotein (MOG) antibodies. The initial clinical and magnetic resonance imaging (MRI) features, as well as those observed over time, are highlighted, emphasizing the distinct and overlapping features of each of these disorders.

scholarly journals Pain, Depression, and Quality of Life in Neuromyelitis Optica Spectrum Disorder

2021 ◽  
Vol 8 (3) ◽  
pp. e985
Author(s):  
Ilya Ayzenberg ◽  
Daniel Richter ◽  
Eugenia Henke ◽  
Susanna Asseyer ◽  
Friedemann Paul ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Neuromyelitis Optica ◽  
Clinical Characteristics ◽  
Short Form ◽  
Spectrum Disorder ◽  
Pain Severity ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Upper Thoracic

ObjectivesTo evaluate prevalence, clinical characteristics, and predictors of pain, depression, and their impact on the quality of life (QoL) in a large neuromyelitis optica spectrum disorder (NMOSD) cohort.MethodsWe included 166 patients with aquaporin-4–seropositive NMOSD from 13 tertiary referral centers. Patients received questionnaires on demographic and clinical characteristics, PainDetect, short form of Brief Pain Inventory, Beck Depression Inventory–II, and Short Form 36 Health Survey.ResultsOne hundred twenty-five (75.3%) patients suffered from chronic NMOSD-associated pain. Of these, 65.9% had neuropathic pain, 68.8% reported spasticity-associated pain and 26.4% painful tonic spasms. Number of previous myelitis attacks (OR = 1.27, p = 0.018) and involved upper thoracic segments (OR = 1.31, p = 0.018) were the only predictive factors for chronic pain. The latter was specifically associated with spasticity-associated pain (OR = 1.36, p = 0.002). More than a third (39.8%) suffered from depression, which was moderate to severe in 51.5%. Pain severity (OR = 1.81, p < 0.001) and especially neuropathic character (OR = 3.44, p < 0.001) were associated with depression. Pain severity and walking impairment explained 53.9% of the physical QoL variability, while depression and walking impairment 39.7% of the mental QoL variability. No specific medication was given to 70.6% of patients with moderate or severe depression and 42.5% of those with neuropathic pain. Two-thirds (64.2%) of patients with symptomatic treatment still reported moderate to severe pain.ConclusionsMyelitis episodes involving upper thoracic segments are main drivers of pain in NMOSD. Although pain intensity was lower than in previous studies, pain and depression remain undertreated and strongly affect QoL. Interventional studies on targeted treatment strategies for pain are urgently needed in NMOSD.

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