Dorsal midbrain involvement in MRI as a core clinical manifestation for NMOSD diagnosis

Etemadifar, Masoud; Sabeti, Fatemeh; Ebrahimian, Shadi; Momeni, Fatemeh

doi:10.1016/j.msard.2020.102150

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…The most frequent finding in brain MRI was the periventricular lesions found in 94.4% in line with other studies from Kuwait (83.3%), 25 Iran (67.7%) 72 and from Europe 71 . This reported high frequency of periventricular lesions might suggest genetic differences in the distribution of the target channel or a point of entry of the pathogenic autoantibodies 73 .…”

Section: Discussionsupporting

confidence: 89%

Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Nasreldein

Farweez

El-Fetoh

et al. 2022

Clinical & Exp Neuroim

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Background Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating disease of the central nervous system, which mainly affects the optic nerves and the spinal cord. Magnetic resonance imaging (MRI) plays an important role in the diagnosis of NMOSD based on the 2015 consensus criteria. Methods The objective of this study was to describe the MRI characteristics of NMOSD patients in Egypt. This were a prospective, observational study on patients fulfilling the 2015 diagnostic criteria of NMOSD. Patients were recruited consecutively from the Neurology, Psychiatry and Neurosurgery hospital, Assiut University Hospitals, Egypt from March 2019 until August 2020. Data on demographics, clinical and laboratory features were collected. MRI scan results were reviewed for each patient and compared according to Aquaporin4‐seropositivity. Results Ninety patients fulfilled NMOSD diagnostic criteria. The mean age at onset was 30.7±11.8 with a female predominance of 3:1. AQP4 antibodies were positive in 77/90 patients (85.6%). Seventy‐two patients (80%) had acute myelitis, 44 cases (61.1%) had longitudinally extensive transverse myelitis (LETM) and 61 cases (87.1%) had a central position in the cord. Bright spotty lesions (BSL) were found in 44 cases (61.1%). The most common site of cord involvement was the cervical region. Abnormal MRI brain scans were found in 81.1% of patients. No statistically significant differences could be found between the two groups. Conclusion There was a high frequency of abnormal spine and brain MRI findings in the Egyptian population. Even though no specific patterns were typical for AQP4‐specific serostatus, certain findings may suggest NMOSD diagnosis and warrant AQP4‐IgGs testing.

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Section: Discussionsupporting

confidence: 89%

Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Nasreldein

Farweez

El-Fetoh

et al. 2022

Clinical & Exp Neuroim

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“…Therefore, due to differences in brainstem lesions caused by AQP4 antibodies, patients may also present with diplopia, vertigo, headache, and facial hypoesthesia as initial symptoms. Diplopia may be the second most common symptom of brainstem following area postrema syndrome [ [16] , [17] , [18] , [19] ], possibly because the nerve nuclei and fibers controlling eye movements are partly located in the dorsal brainstem around the ventricle where AQP4 is enriched. These symptoms are not specific, and early stage patients are easily misdiagnosed with other brainstem diseases, such as brainstem infarction and multiple sclerosis [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Neuromyelitis optica spectrum disorder with acute brainstem manifestations as initial symptoms

Li,

Yang,

Pan

et al. 2024

Heliyon

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“…A particularly striking lesion of NMOSD is a T2/ FLAIR high signal involving the peri-aqueductal grey matter (Figure 3r). Sometimes these lesions of the posterior mid-brain can be large [42,79,136]. Lesions of the anterior mid-brain, both linear peri-ependymal [42] and extensions of longitudinal corticospinal tract lesions through the cerebral peduncles, have been described [91,92,109,137].…”

Section: Brain Stem and Cerebellummentioning

confidence: 99%

Magnetic resonance imaging in neuromyelitis optica spectrum disorder

Clarke

Arnett

Lilley

et al. 2021

Clinical and Experimental Immunology

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Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disease of the central nervous system (CNS) associated with antibodies to aquaporin-4 (AQP4), which has distinct clinical, radiological and pathological features, but also has some overlap with multiple sclerosis and myelin oligodendrocyte glycoprotein (MOG) antibody associated disease. Early recognition of NMOSD is important because of differing responses to both acute and preventive therapy. Magnetic resonance (MR) imaging has proved essential in this process. Key MR imaging clues to the diagnosis of NMOSD are longitudinally extensive lesions of the optic nerve (more than half the length) and spinal cord (three or more vertebral segments), bilateral optic nerve lesions and lesions of the optic chiasm, area postrema, floor of the IV ventricle, periaqueductal grey matter, hypothalamus and walls of the III ventricle. Other NMOSD-specific lesions are denoted by their unique morphology: heterogeneous lesions of the corpus callosum, 'cloud-like' gadolinium (Gd)-enhancing white matter lesions and 'bright spotty' lesions of the spinal cord. Other lesions described in NMOSD, including linear periventricular peri-ependymal lesions and patch subcortical white matter lesions, may be less specific.The use of advanced MR imaging techniques is yielding further useful information regarding focal degeneration of the thalamus and optic radiation in NMOSD and suggests that paramagnetic rim patterns and changes in normal appearing white matter are specific to MS. MR imaging is crucial in the early recognition of NMOSD and in directing testing for AQP4 antibodies and guiding immediate acute treatment decisions.Increasingly, MR imaging is playing a role in diagnosing seronegative cases of NMOSD.

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Dorsal midbrain involvement in MRI as a core clinical manifestation for NMOSD diagnosis

Cited by 6 publications

References 31 publications

Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Radiological characteristics of neuromyelitis optica spectrum disorder in Egypt

Neuromyelitis optica spectrum disorder with acute brainstem manifestations as initial symptoms

Magnetic resonance imaging in neuromyelitis optica spectrum disorder

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