Late onset neuromyelitis optica mimicking an acute stroke in an elderly patient

Suchdev, Kushak; Razmjou, Sara; Venkatachalam, Praveen; Khan, Omar; Mohamed, Wazim; Ibrahim, M. S.

doi:10.1016/j.jneuroim.2017.04.006

Cited by 14 publications

(10 citation statements)

References 11 publications

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“…Suchdev et al 17 highlighted this when an elderly patient with AQP4 antibodies (AQP4-Ab) presented with sudden-onset transverse myelitis initially thought to be vascular 17…”

Section: Hyperacute Onsetmentioning

confidence: 99%

A practical approach to the diagnosis of spinal cord lesions

et al. 2018

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Every neurologist will be familiar with the patient with atypical spinal cord disease and the challenges of taking the diagnosis forward. This is predominantly because of the limited range of possible clinical and investigation findings making most individual features non-specific. The difficulty in obtaining a tissue diagnosis further contributes and patients are often treated empirically based on local prevalence and potential for reversibility. This article focuses on improving the diagnosis of adult non-traumatic, non-compressive spinal cord disorders. It is structured to start with the clinical presentation in order to be of practical use to the clinician. We aim, by combining the onset phenotype with the subsequent course, along with imaging and laboratory features, to improve the diagnostic process.

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“…Suchdev et al 17 highlighted this when an elderly patient with AQP4 antibodies (AQP4-Ab) presented with sudden-onset transverse myelitis initially thought to be vascular 17…”

Section: Hyperacute Onsetmentioning

confidence: 99%

A practical approach to the diagnosis of spinal cord lesions

et al. 2018

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“…Older patients with NMOSD often present with an insidious onset of symptoms and aggressive progression [18–23], which inspired articles on late onset NMOSD (LO‐NMOSD) [21,24,25]. Although few papers have reported anecdotally on very late onset (VLO)‐NMOSD [18,19,23–26], case series with a focus on VLO‐NMOSD are rare. Therefore, the aim of this retrospective study was to compare the clinical features of VLO‐NMOSD as well as early and late onset groups.…”

Section: Introductionmentioning

confidence: 99%

“…Older patients with NMOSD often present with an insidious onset of symptoms and aggressive progression [18][19][20][21][22][23], which inspired articles on late onset NMOSD (LO-NMOSD) [21,24,25]. Although few papers have reported anecdotally on very late onset (VLO)-NMOSD [18,19,[23][24][25][26], case series with a focus on VLO-NMOSD are rare.…”

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confidence: 99%

Very late onset neuromyelitis optica spectrum disorders

Nakahara

Nakane

Nagaishi

et al. 2021

Euro J of Neurology

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Aging is defined as a "physiologically progressive, generalized degeneration and decay of somatic tissues and immune system with increasing probability of death" [1]. In elderly individuals, the immune system changes T-cell subsets in the form of cellular and molecular alterations and thymic atrophy, which results in reduced function of T and B cells [2-4]. Furthermore, the immune system is prone to autoimmune responses, and the incidence of several autoimmune diseases is higher, or they are preferentially encountered, in the elderly [5,6]. We previously reported the incidence of elderly onset myasthenia gravis in Japan and discussed the relationship between clinical features and immunological background [7].Neuromyelitis optica spectrum disorder (NMOSD) is a severe demyelinating autoimmune disorder that primarily affects the optic

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“…Anti-aquaporin 4 (AQP4) Abs are highly speci c for NMOSD [9,10,12,14] The usual age of onset in NMO is the 30s or 40s [15]; however, NMOSD in the elderly has recently been reported as not uncommon [16,17]. Older patients with NMOSD often present with insidious onset of symptoms and aggressive progression [18][19][20][21][22][23], which inspired articles on late-onset NMOSD (LO-NMOSD) [21,24,25]. Although few papers have reported anecdotally on very lateonset (VLO)-NMOSD [18,19,[23][24][25][26], case series with a focus on VLO-NMOSD are rare.…”

Section: Introductionmentioning

confidence: 99%

“…Older patients with NMOSD often present with insidious onset of symptoms and aggressive progression [18][19][20][21][22][23], which inspired articles on late-onset NMOSD (LO-NMOSD) [21,24,25]. Although few papers have reported anecdotally on very lateonset (VLO)-NMOSD [18,19,[23][24][25][26], case series with a focus on VLO-NMOSD are rare. Therefore, the aim of this retrospective study was to identify the clinical features of VLO-NMOSD as compared to early and late onset groups.…”

Section: Introductionmentioning

confidence: 99%

Aging, immunosenescense, and very late-onset neuromyelitis optica spectrum disorders

Nakahara¹,

Nakane²,

Ando³

2020

Preprint

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Objective: To clarify the clinical features of very late-onset neuromyelitis optica spectrum disorders NMOSD (VLO-NMOSD).Methods: According to the age at onset, we classified patients with NMOSD into three subgroups of early-onset NMOSD (EO-NMOSD), late-onset NMOSD (LO-NMOSD), and VLO-NMOSD. We evaluated the clinical characteristics, MRI findings, laboratory data, and immunotherapies among the groups.Results: Overall, eight males and 36 females with a median age at onset of 43.00 years (interquartile range, 29.00–54.75) and median duration of disease of 6.00 months (interquartile range, 3.00–11.75) were included. This included 7 (16%) patients with VLO-NMOSD, 11 (25%) with LO-NMOSD, and 26 (59%) with EO-NMOSD. Patients with EO-NMOSD had significantly longer disease duration than those did with VLO-NMOSD and LO-NMOSD (p=0.015). Optic nerve lesions on MRI and optic neuritis were significantly less frequent in patients with VLO-NMOSD than in those with LO-NMOSD and EO-NMOSD (p=0.013 and p=0.046, respectively), whereas the length of the spinal lesion was significantly longer in those with VLO-NMOSD in comparison with those with LO-NMOSD and EO-NMOSD (p=0.038).Conclusions: Spinal cord lesion in patients with VLO-NMOSD was significantly longer despite short disease duration, and optic neuritis was significantly less frequent in them.

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Late onset neuromyelitis optica mimicking an acute stroke in an elderly patient

Cited by 14 publications

References 11 publications

A practical approach to the diagnosis of spinal cord lesions

A practical approach to the diagnosis of spinal cord lesions

Very late onset neuromyelitis optica spectrum disorders

Aging, immunosenescense, and very late-onset neuromyelitis optica spectrum disorders

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