Neuromyelitis optica is also called neuromyelitis optica spectrum disorder or Devic’s disease.
Magnetic resonance imaging of the cervical spinal cord-axial T2-weighted sequences. Photo: Case Reported in the National Library of Medicine in the United States.
A Puerto Rican woman suffered from intractable hiccups for about 15 years, unaware that this was just a syndrome of a central nervous system disorder, known as neuromyelitis optica (NMOSD), which raises a medical alert among health professionals, in the face of this type of diagnosis that could go unnoticed.
The reported case relates that a 46-year-old woman presented with intractable hiccups when she was 31 years old (2004). During her process, she was admitted to a New York hospital, where she has not yet been diagnosed, despite the fact that she lost much of the vision in her left eye, according to data from the report.
After almost 15 years since the first symptom, and two severe relapses, he received a formal diagnosis of NMOSD in March 2019, when he arrived in Puerto Rico in search of a neurology specialist, Dr. Angel Chinea, who ordered an MRI study of the brain and cervical, together with an antibody test against aquaporin (AQP4).
In addition, the case report states that she was treated with 500 mg of intravenous methylprednisolone for three days to reduce symptoms. After evaluation of the studies performed, the patient formally received a diagnosis of NMOSD.
Treatment began with rituximab -a monoclonal antibody- in April 2019. However, the lack of response to treatment led to a change to therapy with eculizumab -another monoclonal antibody- in August 2019.
The patient underwent a cervical and brain MRI scan again in 2020, which showed a noticeable decrease
in swelling and hyperintensity within the cervical spinal cord without lesions, compared to the first MRI of 2019. In addition, the patient suffered no new relapses.
However, this substantial decrease does not occur in all NMOSD patients, but greater awareness of the disease is needed, especially in Puerto Rico, the authors of the case argue, which in turn illustrates the efficacy of eculizumab therapy and the importance of differentiating the clinical, histopathological and neuroimaging features that separate inflammatory autoimmune demyelinating disorders, such as NMOSD and multiple sclerosis (MS).
The neuromyelitis optica is a disorder of the central nervous system that mainly affects the nerves of the eye (optic neuritis) and the spinal cord (myelitis). The neuromyelitis optica Also called a spectrum disorder neuromyelitis optica or Devic’s disease.
Access the case here.