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
Citations
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Resolution of inflammation in neuromyelitis optica spectrum disorders.
Xu Wang,Wenyu Jiao,Meng Lin,Chao Lu,Caiyun Liu,Ying Wang,Di Ma,Xiuzhe Wang,Ping Yin,Jiachun Feng,Jie Zhu,Mingqin Zhu +11 more
TL;DR: Investigation of the levels of SPMs in the serum and cerebrospinal fluid of NMOSD patients showed decreased RvD1 levels indicate impaired resolution of inflammation in NMOSd patients, and AQP4-IgG may contribute to increased inflammation and lead to unresolved inflammation inNMOSD.
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Ocular Oscillations in the Neuromyelitis Optica Spectrum
TL;DR: Four French West Indian women complained of oscillopsia and were found to have an acquired eye movement disorder, including upbeat, downbeat, and central form of vestibular nystagmus, which is proposed to be added to the neurological manifestations of NMO.
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Neuromyelitis optica spectrum disorder (NMOSD): A new concept
TL;DR: An overview of the clinical and neuroimaging features of NMOSD is provided, followed by its treatment.
References
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Journal ArticleDOI
Applied Logistic Regression.
TL;DR: Applied Logistic Regression, Third Edition provides an easily accessible introduction to the logistic regression model and highlights the power of this model by examining the relationship between a dichotomous outcome and a set of covariables.
Journal ArticleDOI
Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis
W. Ian McDonald,A Compston,Gilles Edan,Donald E. Goodkin,Hans-Peter Hartung,Fred D. Lublin,Henry F. McFarland,Donald W. Paty,Chris H. Polman,Stephen C. Reingold,Magnhild Sandberg-Wollheim,William A. Sibley,Alan J. Thompson,Stanley van den Noort,Brian Y. Weinshenker,Jerry S. Wolinsky +15 more
TL;DR: The revised criteria facilitate the diagnosis of MS in patients with a variety of presentations, including “monosymptomatic” disease suggestive of MS, disease with a typical relapsing‐remitting course, and disease with insidious progression, without clear attacks and remissions.
Book
Clinical Epidemiology: A Basic Science for Clinical Medicine
TL;DR: Clinical Epidemiology is a book dedicated to H.L. Mencken, Kurt Vonnegut, Jr., Douglas Adams, and the Emperor's New Clothes and Physicians and others who wish to recognize key clinical epidemiologic features of the diagnosis and management of patients will benefit from reading.
Journal ArticleDOI
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.
Journal ArticleDOI
IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel.
TL;DR: It is shown that NMO-IgG binds selectively to the aquaporin-4 water channel, a component of the dystroglycan protein complex located in astrocytic foot processes at the blood-brain barrier, which may represent the first example of a novel class of autoimmune channelopathy.
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