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Updated: May 26, 2026
12:23
Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
Published on: April 14, 2014
Neuromyelitis optica: atipic clinic presentation
Emine Rabia Koç1, Alevtina Ersoy, Atilla Ilhan
1Department of Neurology, Fatih University School of Medicine, Fatih Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, Alparslan Türkeş Cad. No:57, 06510, Emek, Ankara, Turkey. erabiakoc@yahoo.com
Summary
Neuromyelitis optica can occur in elderly patients with isolated spinal cord lesions. Visual evoked potentials and aquaporin-4 IgG testing are crucial for diagnosing subclinical optic neuritis in these cases.
Area of Science:
- Neuroimmunology
- Neurology
- Ophthalmology
Background:
- Neuromyelitis optica (NMO) is a rare autoimmune disease primarily affecting the optic nerves and spinal cord.
- Traditionally, NMO diagnosis involves optic neuritis and myelitis, often with aquaporin-4 IgG (AQP4-IgG) antibodies.
Observation:
- This case study details an elderly patient presenting with longitudinally extensive transverse myelitis (LETM) as the sole initial clinical manifestation.
- Clinical examination did not reveal overt signs of optic neuritis.
Findings:
- Despite the absence of clinical optic neuritis, visual evoked potentials (VEPs) demonstrated subclinical optic nerve involvement, indicated by a prolonged P100 latency.
- The patient was positive for aquaporin-4 IgG antibodies, confirming the diagnosis of NMO spectrum disorder.
Implications:
- Neuromyelitis optica should be considered in the differential diagnosis of elderly patients presenting with isolated LETM.
- Subclinical optic nerve involvement, detectable via VEPs, is significant in NMO diagnosis.
- AQP4-IgG antibody testing is essential for confirming NMO, even in the presence of atypical presentations.
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