Neuromyelitis optica: clinical manifestations and neuroimaging features

Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disease of the central nervous system with distinguishing features from multiple sclerosis. Understanding of clinical presentation, immunopathology, and imaging features has changed during the last decade. The identification of NMO immunoglobulin G and aquaporin 4 as the target antigen in this disease helped to define the NMO spectrum of disorders and showed that NMO is an autoimmune channelopathy of the central nervous system. Several types of brain involvement have been described in patients with NMO. This article discusses the epidemiology, clinical manifestations, and immunopathogenesis of the disease with an emphasis on neuroimaging.