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Related Experiment Video

Updated: Jun 13, 2026

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4

Published on: August 21, 2017

Neuromyelitis optica with hypothalamic involvement: a case report.

Kusuma Samart¹, Kammant Phanthumchinda

¹Division ofNeurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Nunan123@yahoo.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet

|May 14, 2010

Summary

Neuromyelitis Optica (NMO) diagnosis criteria may need updating. This case highlights uncommon hypothalamic and brainstem lesions, suggesting their inclusion for better NMO diagnosis.

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Last Updated: Jun 13, 2026

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4

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Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

Published on: April 14, 2014

Area of Science:

Neuroimmunology
Neurology
Clinical Diagnostics

Background:

Current Neuromyelitis Optica (NMO) diagnostic criteria require acute optic neuritis and myelitis, plus two supportive criteria including specific MRI findings or NMO-IgG seropositivity.
The case presents a 34-year-old woman with recurrent central nervous system demyelinating events over three years.

Observation:

The patient experienced initial symptoms including neck pain, oscillopsia, vertigo, and weakness with cervicomedullary junction lesions on MRI, responding to corticosteroids.
A subsequent episode of bilateral optic neuritis was treated with high-dose corticosteroids, followed by azathioprine.
Further symptoms included hypersomnia, confabulation, and significant neurological deficits (quadriparesis, sensory loss, autonomic dysfunction) with extensive brain and spinal cord lesions, including the hypothalamus and brainstem.

Findings:

Brain MRI revealed lesions in the hypothalamus, tuber cinereum, thalami, dorsal midbrain, and occipital periventricular white matter.
Spinal MRI demonstrated extensive multilevel lesions from the medulla down to the thoracic cord.
Cerebrospinal fluid analysis showed lymphocytic pleocytosis, with negative oligoclonal bands.

Implications:

The observed hypothalamic and brainstem involvement, while uncommon, are considered pathognomonic for NMO.
The authors propose incorporating hypothalamic and brainstem lesion evaluation into the diagnostic criteria for NMO.
This could lead to earlier and more accurate diagnosis of NMO, especially in cases with atypical presentations.