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Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4
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Meningoencephalitis as an initial manifestation of neuromyelitis optica spectrum disorder

Jin-Ye Wang1, Kai Wang, Xian-Wen Chen

  • 1Department of Neurology, the First Affiliated Hospital of Anhui Medical University, China.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|October 17, 2012
PubMed

Insights

Neuromyelitis optica spectrum disorder (NMOSD) can mimic infections with symptoms like headache and fever. Characteristic MRI findings are crucial for diagnosing NMOSD, especially when it presents as meningoencephalitis.

Area of Science:

  • Neuroimmunology
  • Neurology

Background:

  • Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease targeting the central nervous system.
  • Distinguishing NMOSD from infectious meningoencephalitis is clinically important.

Observation:

  • Two patients presented with headache, fever, and subsequent disturbance of consciousness.
  • Cerebrospinal fluid analysis revealed significant pleocytosis (>500×10²/L).
  • Magnetic resonance imaging (MRI) identified multiple brain lesions at sites of high aquaporin-4 (AQP-4) expression.

Findings:

  • Both patients were positive for serum AQP-4 antibodies.
  • Case 1 developed optic neuritis; Case 2 developed myelitis, confirming NMOSD diagnosis.
  • The cases highlight NMOSD's potential initial presentation as meningoencephalitis.

Implications:

  • Characteristic MRI findings are critical for differentiating NMOSD from intracranial infections.
  • Early and accurate diagnosis of NMOSD is essential for appropriate management.
  • This presentation underscores the importance of considering NMOSD in cases of unexplained meningoencephalitis.

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