“…As indicated in Table 1, our case and the previous three NMOSD cases with a leukodystrophy-like MRI pattern were, overall, anti-AQP4-positive, long-standing NMOSD (disease duration ≥9 years), and mainly presented with either optic neuritis or myelitis with no or only a few encephalopathy and cerebellar symptoms, despite the presence of extensive brain white-matter lesions 234. An especially notable point is that all of them initially showed normal or only subtle brain MRI changes, indicating that leukodystrophy-like white-matter lesions are a feature of long-standing disease.…”