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Related Experiment Videos

Brain abnormalities in neuromyelitis optica.

Sean J Pittock1, Vanda A Lennon, Karl Krecke

  • 1Department of Neurology, Laboratory Medicine and Pathology, Radiology, and Immunology, Mayo Clinic College of Medicine, Rochester, Minn, USA.

Archives of Neurology
|March 15, 2006
PubMed
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Brain lesions are common in neuromyelitis optica (NMO), even when asymptomatic. These findings suggest current diagnostic criteria for NMO should be revised to include brain involvement.

Area of Science:

  • Neurology
  • Neuroimmunology
  • Radiology

Background:

  • Neuromyelitis optica (NMO) is a severe demyelinating disease primarily affecting the optic nerves and spinal cord.
  • Current diagnostic criteria for NMO exclude patients with symptoms outside these areas.
  • However, NMO patients often develop brain lesions, necessitating a review of diagnostic criteria.

Purpose of the Study:

  • To characterize magnetic resonance imaging (MRI) findings in the brains of patients diagnosed with NMO.
  • To evaluate the frequency and nature of brain lesions in NMO.
  • To determine if brain involvement should be incorporated into NMO diagnostic criteria.

Main Methods:

  • Retrospective observational case series of 60 patients meeting modified NMO criteria.

Related Experiment Videos

  • Inclusion criteria included spinal cord lesions (≥3 vertebral segments) and neurological/brain MRI evaluation.
  • Brain MRIs were classified as normal, nonspecific, multiple sclerosis-like, or atypical. Symptomatic brain lesions and neuropathology were assessed.

    • Main Results:

    • Brain MRI lesions were identified in 60% of NMO patients (36/60).
    • Lesions included nonspecific (most common), multiple sclerosis-like (10%), and atypical (8%) abnormalities.
    • Brain lesions were often asymptomatic, though symptomatic involvement occurred in some cases.

    Conclusions:

    • Asymptomatic brain lesions are frequently observed in neuromyelitis optica (NMO).
    • The presence of symptomatic brain lesions does not preclude an NMO diagnosis.
    • Existing diagnostic criteria for NMO require revision to accommodate brain involvement.