Diagnosis of neuromyelitis optica (NMO) spectrum disorders: is MRI obsolete?

Downer, Jonathan; Leite, Maria Isabel; Carter, Ranjana; Palace, Jacqueline; Küker, Wilhelm; Quaghebeur, Gerardine

doi:10.1007/s00234-011-0875-x

Cited by 45 publications

(64 citation statements)

References 30 publications

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“…As a substantial portion of NMO patients in clinic have brain involvement, further study should identify which imaging features are truly characteristic of NMO, and can be included in the diagnostic workup. Conversely, our clinical experience and another study [7] also support that presence of typical MS lesions cannot exclude the clinical diagnosis of NMO, particularly in the Asian populations. A Japanese study showed that brain MRI lesions (including typical ovoid periventricular lesions) were indistinguishable between MS and NMO [8].…”

Section: Introductionsupporting

confidence: 53%

Brain MRI in Neuromyelitis Optica: What is its Role?

Qiu

Kermode

2011

Curr Neurol Neurosci Rep

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Section: Introductionsupporting

confidence: 53%

Brain MRI in Neuromyelitis Optica: What is its Role?

Qiu

Kermode

2011

Curr Neurol Neurosci Rep

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“…These longitudinally extensive spinal cord lesions (LESCLs) are commoner in AQP4 positive patients than those who are negative for the antibody and patient may show short segment T2 hyper-intense lesions on imaging. Delayed imaging after the beginning of symptoms may also result in short segment lesions [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…The optic nerves may show bilateral involvement, altered signal intensity with posterior extension into the optic chiasma and contrast enhancement [12,13]. In the acute phase, pulse dose methyl-prednisolone therapy is the treatment of choice followed by tapering dose of oral steroid for 2-6 months.…”

Section: Discussionmentioning

confidence: 99%

Sero-Negative Neuromyelitis Optica

Bhargava¹,

Upadhayaya²,

Dixit³

et al. 2017

JCR

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Background: Neuromyelitis optica (NMO, Devic's syndrome) is an immune mediated inflammatory demyelinating disease of the central nervous system that predominantly affects the spinal cord and optic nerves. Often confused with multiple sclerosis (MS), early diagnosis and differentiation from MS is important because of different treatment regimens. Case Report: We hereby report a sero-negative mono-phasic manifestation of this rare disease in a nine year old Indian boy. NMO was diagnosed in our case despite being sero-negative because of typical clinical findings and evidence of myelitis and optic neuritis seen in MRI. Patient was treated with pulse methyl-prednisolone followed by oral prednisolone and patient improved with some residual deformity. Conclusion: High index of suspicion is required to diagnose and treat patients at an early stage to prevent co-morbidities and complications.

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“…In such cases, we have observed short segments of gadolinium enhancement within pre-existing T2 LESCLs during acute spinal relapse (Fig 1A, -B). Additionally, short-segment T2-hyperintense lesions are described in NMO 20 and should not necessarily deter one from the diagnosis, particularly in the presence of other typical neuroimaging findings. While cord pathology in NMO is traditionally associated with a severe clinical phenotype, including the need for ventilatory support in association with high cervical lesions, excellent clinical and radiologic recovery may be seen in some patients.…”

Section: Typical Spinal Cord Imaging Featuresmentioning

confidence: 98%

Conventional and Advanced Imaging in Neuromyelitis Optica

Barnett

Sutton

Ghadiri

et al. 2013

American Journal of Neuroradiology

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SUMMARY:Myelitis and optic neuritis are prototypic clinical presentations of both multiple sclerosis and neuromyelitis optica. Once considered a subtype of multiple sclerosis, neuromyelitis optica, is now known to have a discrete pathogenesis in which antibodies to the water channel, aquaporin 4, play a critical role. Timely differentiation of neuromyelitis optica from MS is imperative, determining both prognosis and treatment strategy. Early, aggressive immunosuppression is required to prevent the accrual of severe disability in neuromyelitis optica; conversely, MS-specific therapies may exacerbate the disease. The diagnosis of neuromyelitis optica requires the integration of clinical, MR imaging, and laboratory data, but current criteria are insensitive and exclude patients with limited clinical syndromes. Failure to recognize the expanding spectrum of cerebral MR imaging patterns associated with aquaporin 4 antibody seropositivity adds to diagnostic uncertainty in some patients. We present the state of the art in conventional and nonconventional MR imaging in neuromyelitis optica and review the place of neuroimaging in the diagnosis, management, and research of the condition. ABBREVIATIONS: AQP4 ϭ aquaporin 4; LESCL ϭ longitudinally extensive spinal cord lesion; MT ϭ magnetization transfer; NMO ϭ neuromyelitis optica

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Diagnosis of neuromyelitis optica (NMO) spectrum disorders: is MRI obsolete?

Cited by 45 publications

References 30 publications

Brain MRI in Neuromyelitis Optica: What is its Role?

Brain MRI in Neuromyelitis Optica: What is its Role?

Sero-Negative Neuromyelitis Optica

Conventional and Advanced Imaging in Neuromyelitis Optica

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