A Benign Form of Neuromyelitis Optica

Collongues, Nicolas

doi:10.1001/archneurol.2011.127

Cited by 49 publications

(37 citation statements)

References 26 publications

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“…The timing of MRI in the evolution of NMOSD also may influence the length of the imaged lesion; 18 early imaging may miss a long lesion 11 and late imaging may reveal a discontinuous or short lesion, or no lesion. 18, 20 The interval from symptom onset to MRI did not differ significantly for patients with LETM or STM; imaging was performed within 90 days of symptom onset in all patients, and lesional activity was confirmed by gadolinium enhancement in 56% of seropositive STM episodes. In AQP4-IgG positive NMOSD patients evaluated at the time of STM attack, the severity of myelitis at nadir was milder than those with LETM.…”

Section: Discussionmentioning

confidence: 95%

Short Myelitis Lesions in Aquaporin-4-IgG–Positive Neuromyelitis Optica Spectrum Disorders

et al. 2015

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Section: Discussionmentioning

confidence: 95%

Short Myelitis Lesions in Aquaporin-4-IgG–Positive Neuromyelitis Optica Spectrum Disorders

et al. 2015

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“…In the current study, VA results were similar to that of previous studies; however, visual recovery during the remission period at the first ON attack was not significantly different between groups. Recent studies have found that a substantial number of NMO cases are usually associated with mild symptoms or a benign long-term course [33,34]; therefore, the outcome of a single isolated ON case cannot be determined according to VA recovery at first onset.…”

Section: Discussionmentioning

confidence: 99%

Features of anti-aquaporin 4 antibody-seropositive Chinese patients with neuromyelitis optica spectrum optic neuritis

Wang

et al. 2015

J Neurol

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The detection of anti-aquaporin-4 autoantibody (AQP-4 Ab) is crucial to detect patients who will develop neuromyelitis optica (NMO); however, there are few studies on the AQP-4 Ab serostatus of patients with neuromyelitis optica spectrum ON. We analyzed the clinical and paraclinical features of neuromyelitis optica spectrum ON patients in China according to the patients' AQP4-Ab serostatus. 125 patients with recurrent and bilateral ON with simultaneous attacks were divided into AQP-4 Ab-seropositive and -seronegative groups. Demographic, clinical, serum autoantibody data, connective tissue disorders (CTDs), visual performance were compared. A Visual Acuity (VA) of less than 0.1 during acute ON attacks occurred more frequently in the seropositive group (p = 0.023); however, there was not a significant difference between groups on VA recovery after the first attack. The seropositive group experienced the worst outcome during the last attack (p = 0.017). Other co-existing autoimmunity antibodies (p < 0.001) and CTDs (p < 0.001) were more prevalent in seropositive patients. There were no significant differences on VA recovery and RNFLT combined with other autoantibodies or CTDs. The two groups did not differ significantly with regard to time to relapse, annualized relapse rates, time of diagnosis NMO, or RNFL. There were no significant differences on VA recovery and RNFLT combined with other autoantibodies or CTDs. RNFLT was thinner in NMO seropositive patients. Although AQP-4 Ab expression predicted poor visual outcome, positive patients were usually associated with mild symptoms at first onset. Anti-SSA/SSB antibody or Sjögren syndrome may be associated with AQP-4 Ab in neuromyelitis optica spectrum ON.

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“…This is based on two principles: first, that there is no ‘benign’ NMO 81. Second, if AQP4-antibodies are present, then relapses are invariable at some point.…”

Section: Treating Nmosdmentioning

confidence: 99%

Current concept of neuromyelitis optica (NMO) and NMO spectrum disorders

Jacob

McKeon

Nakashima

et al. 2012

Journal of Neurology, Neurosurgery & Psychiatry

161

116

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Neuromyelitis optica (NMO) has been described as a disease clinically characterised by severe optic neuritis (ON) and transverse myelitis (TM). Other features of NMO include female preponderance, longitudinally extensive spinal cord lesions (>3 vertebral segments), and absence of oligoclonal IgG bands . In spite of these differences from multiple sclerosis (MS), the relationship between NMO and MS has long been controversial. However, since the discovery of NMO-IgG or aquaporin-4 (AQP4) antibody (AQP4-antibody), an NMO-specific autoantibody to AQP4, the dominant water channel in the central nervous system densely expressed on end-feet of astrocytes, unique clinical features, MRI and other laboratory findings in NMO have been clarified further. AQP4-antibody is now the most important laboratory finding for the diagnosis of NMO. Apart from NMO, some patients with recurrent ON or recurrent longitudinally extensive myelitis alone are also often positive for AQP4-antibody. Moreover, studies of AQP4-antibody-positive patients have revealed that brain lesions are not uncommon in NMO, and some patterns appear to be unique to NMO. Thus, the spectrum of NMO is wider than mere ON and TM. Pathological analyses of autopsied cases strongly suggest that unlike MS, astrocytic damage is the primary pathology in NMO, and experimental studies confirm the pathogenicity of AQP4-antibody. Importantly, therapeutic outcomes of some immunological treatments are different between NMO and MS, making early differential diagnosis of these two disorders crucial. We provide an overview of the epidemiology, clinical and neuroimaging features, immunopathology and therapy of NMO and NMO spectrum disorders.

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A Benign Form of Neuromyelitis Optica

Cited by 49 publications

References 26 publications

Short Myelitis Lesions in Aquaporin-4-IgG–Positive Neuromyelitis Optica Spectrum Disorders

Short Myelitis Lesions in Aquaporin-4-IgG–Positive Neuromyelitis Optica Spectrum Disorders

Features of anti-aquaporin 4 antibody-seropositive Chinese patients with neuromyelitis optica spectrum optic neuritis

Current concept of neuromyelitis optica (NMO) and NMO spectrum disorders

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