Neuromyelitis optica with simultaneous occurrence of optic neuritis and transverse myelitis

Jayasree Sankunni NAIR, Mohan RAMALINGAM, Nayan JOSHI

Department of Ophthalmology, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam

 ABSTRACT

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease that preferentially affects the optic nerves and spinal cord. It has a worldwide distribution and distinctive clinical, neuroimaging and laboratory findings that distinguish it from multiple sclerosis. In most cases there is a long interval between the optic neuritis and myelitis but approximately 10 to 20% can have near simultaneous occurrence of both. We report a case of NMO presenting with symptoms and signs of optic neuritis and transverse myelitis which was later confirmed by neuroimaging and laboratory findings. The acute attack was treated with pulse therapy of corticosteroid and subsequently the patient was maintained on Azathioprine and tapering dose of oral steroid. This case highlights a neurological disorder that is increasing in prominence and may become more relevant in our region with increased diagnostic utility of antibody testing.

Keywords: Demyelination, optic neuritis, transverse myelitis, NMO IgG, aquaporin 4

Correspondence author: Jayasree S NAIR, Department of Ophthalmology, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam.

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Brunei Int Med J. 2012; 8 (5): 265-270