Revised diagnostic criteria for neuromyelitis optica
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TLDR
Revised diagnostic criteria for definite neuromyelitis optica (NMO) that require optic neuritis, myelitis, and at least two of three supportive criteria: MRI evidence of a contiguous spinal cord lesion 3 or more segments in length, onset brain MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity.Abstract:
Background: The authors previously proposed diagnostic criteria for neuromyelitis optica (NMO) that facilitate its distinction from prototypic multiple sclerosis (MS) However, some patients with otherwise typical NMO have additional symptoms not attributable to optic nerve or spinal cord inflammation or have MS-like brain MRI lesions Furthermore, some patients are misclassified as NMO by the authors’ earlier proposed criteria despite having a subsequent course indistinguishable from prototypic MS A serum autoantibody marker, NMO-IgG, is highly specific for NMO The authors propose revised NMO diagnostic criteria that incorporate NMO-IgG status Methods: Using final clinical diagnosis (NMO or MS) as the reference standard, the authors calculated sensitivity and specificity for each criterion and various combinations using a sample of 96 patients with NMO and 33 with MS The authors used likelihood ratios and logistic regression analysis to develop the most practical and informative diagnostic model Results: Fourteen patients with NMO (146%) had extra-optic-spinal CNS symptoms NMO-IgG seropositivity was 76% sensitive and 94% specific for NMO The best diagnostic combination was 99% sensitive and 90% specific for NMO and consisted of at least two of three elements: longitudinally extensive cord lesion, onset brain MRI nondiagnostic for MS, or NMO-IgG seropositivity Conclusions: The authors propose revised diagnostic criteria for definite neuromyelitis optica (NMO) that require optic neuritis, myelitis, and at least two of three supportive criteria: MRI evidence of a contiguous spinal cord lesion 3 or more segments in length, onset brain MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity CNS involvement beyond the optic nerves and spinal cord is compatible with NMOread more
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Journal ArticleDOI
Brain parenchymal damage in neuromyelitis optica spectrum disorder - A multimodal MRI study.
Florence Pache,Hanna Zimmermann,Carsten Finke,Anna Lacheta,Sebastian Papazoglou,Joseph Kuchling,Jens Wuerfel,Bernd Hamm,Klemens Ruprecht,Friedemann Paul,Alexander U. Brandt,Michael Scheel +11 more
TL;DR: The hypothesis of a widespread brain damage in NMOSD is challenged as the optic radiation is the most severely affected region and DTI is currently the most reliable and sensitive technique for brain damage detection inNMOSD.
Journal ArticleDOI
Cognitive performance of neuromyelitis optica patients: comparison with multiple sclerosis
Sandra Vanotti,Evangelina Valeria Cores,Barbara Eizaguirre,Luciana Melamud,Raul C. Rey,Andres Villa +5 more
TL;DR: In this paper, the authors investigated cognitive pattern of patients with neuromyelitis optica (NMO) and compared it with multiple sclerosis (MS) patients' performance, finding that NMO patients showed abnormal performance in verbal fluency, verbal and visual memories, with greater attention deficits.
Journal ArticleDOI
Comparative clinical characteristics of neuromyelitis optica spectrum disorders with and without medulla oblongata lesions
Yanqiang Wang,Lei Zhang,Bingjun Zhang,Yongqiang Dai,Zhuang Kang,Ciyong Lu,Wei Qiu,Xueqiang Hu,Zhengqi Lu +8 more
TL;DR: Longitudinally extensive transverse myelitis were more frequently found in patients with MO lesions, which might be a symbol of more severe neurologic deficits and worse prognosis of NMOSDs.
Journal ArticleDOI
Alemtuzumab use in neuromyelitis optica spectrum disorders: a brief case series
TL;DR: It is concluded that alemtuzumab failed to prevent disabling relapses and poor outcome in neuromyelitis optica (NMO) spectrum disorders and hypothesise that rituximab is more effective, because it causes much more prolonged B lymphocyte depletion than alem T cell depletion.
Journal ArticleDOI
Extensive hemispheric lesions with radiological evidence of blood-brain barrier integrity in a patient with neuromyelitis optica.
Shinji Saiki,Yuji Ueno,Toshio Moritani,Takeshi Sato,Takeshi Sekine,Sumihiro Kawajiri,Satoshi Adachi,Kazumasa Yokoyama,Yuji Tomizawa,Yumiko Motoi,Nobutaka Hattori +10 more
TL;DR: A 36-year-old woman with NMO positive for NMO-IgG is reported to have developed an acute disseminating encephalomyelitis (ADEM)-like episode after Mycoplasma pneumoniae infection, suggesting possible involvement of deficient water elimination associated with seropositivity to N MO-IGG in the induction of vasogenic edema even in the presence of intact and functional BBB.
References
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Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis
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A serum autoantibody marker of neuromyelitis optica : distinction from multiple sclerosis
Vanda A. Lennon,Dean M. Wingerchuk,Thomas J. Kryzer,Sean J. Pittock,C. F. Lucchinetti,Kazuo Fujihara,Ichiro Nakashima,Brian G. Weinshenker +7 more
TL;DR: NMO-IgG is a specific marker autoantibody of neuromyelitis optica and binds at or near the blood-brain barrier that distinguishes neuromyleitis opticas from multiple sclerosis.
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IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel.
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International consensus diagnostic criteria for neuromyelitis optica spectrum disorders
Dean M. Wingerchuk,Brenda Banwell,Jeffrey Bennett,Philippe Cabre,William M. Carroll,Tanuja Chitnis,Jérôme De Seze,Kazuo Fujihara,Benjamin Greenberg,Anu Jacob,Sven Jarius,Marco Aurélio Lana-Peixoto,Michael J. Levy,Jack H. Simon,Silvia Tenembaum,Anthony Traboulsee,Patrick Waters,Kay E. Wellik,Brian G. Weinshenker +18 more