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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Seronegative Neuromyelitis Optica Spectrum - The challenges on disease definition and pathogenesis espectro da neuromielite optica seronegativa - os desafios na definição da doença e sua
Douglas Kazutoshi Sato,Dagoberto Callegaro,Marco Aurélio Lana-Peixoto,Ichiro Nakashima,Kazuo Fujihara +4 more
TL;DR: The clinical features, imaging, and laboratory findings that can be helpful on the diagnostic work-up, and the differences between AQP4 antibody positive and negative patients with NMOSD are discussed, including features ofNMOSD with antibodies against myelin oligodendrocyte glycoprotein.
Journal ArticleDOI
NMO in pediatric patients: brain involvement and clinical expression
TL;DR: Optic neuropathy is the most impaired feature in NMO patients and brain MRI lesions are not compatible with multiple sclerosis and positivity of the NMO-IgG are also present in N MO pediatric patients, confirming the heterogeneity in the expression of this disorder.
Journal ArticleDOI
Familial forms of multiple sclerosis and neuromyelitis optica at an MS center in Rio de Janeiro State, Brazil
Regina Maria Papais-Alvarenga,Fernanda Ferreira Chaves da Costa Pereira,Melina Da Silva Bernardes,Marcos Papais-Alvarenga,Elizabeth Batista,Carmen Lucia Antão Paiva,Claudia M. Miranda Santos,Claudia Cristina Ferreira Vasconcelos +7 more
TL;DR: Familial forms of demyelinating diseases from an MS referral center in Río de Janeiro State, Brazil found only in the multiple sclerosis (MS) and neuromyelitis optica syndrome (NMOSD) categories.
Journal ArticleDOI
A comparison of pediatric and adult neuromyelitis optica spectrum disorders: A review of clinical manifestation, diagnosis, and treatment.
TL;DR: Based on the similarity of clinical, neuroimaging, and laboratory characteristics of pediatric NMOSD to those of the adult form, the international panel suggested that adult criteria ofNMOSD also are appropriate in pediatric patients, however, the proposed criteria need validation in Pediatrics.
Book ChapterDOI
Acute inflammatory myelopathies.
TL;DR: This review focuses on inflammatory spinal cord injury and its relationships with multiple sclerosis, neuromyelitis optica, acute disseminated encephalomyeliitis and systemic collagen vascular and paraneoplastic diseases.
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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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.
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Clinical Epidemiology: A Basic Science for Clinical Medicine
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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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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