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How long does it take to diagnose patients with neuromyelitis optica (NMO) using the 2006 diagnostic criteria?
Tanawat Tengsirikomol1, Sasitorn Siritho2, Naraporn Prayoonwiwat1
1Division of Neurology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Background And Purpose:
A few reports studied the time use to diagnose patient with neuromyelitis optica (NMO). The Aim of the study is to evaluate the interval from disease onset to the time when patients fulfilled the NMO diagnostic criteria 2006 in Thai.
Method:
A retrospective study of the NMO patients visiting the MS clinic and related disorders at Siriraj hospital was reviewed.
Results:
There were 42 definite NMO. All were female. The most common first presentations were optic neuritis (ON) (45.2%), transverse myelitis (TM) (35.7%), ON and TM (9.5%) and brainstem symptoms (9.5%), respectively. The mean age at onset of their ON and TM attack was 33.4 and 38.4 years, respectively. Anti-AQP4 antibody was presented in 82% using cell based assay. For those presented with ON, 7.1% reported painful eye movements and 33.3% had bilateral involvement. Brain MRI not compatible with MS was found in 94.87%. In who presented with TM, 87.8% revealed long extensive transverse myelitis (LETM) in spinal MRI. The presence of CSF-oligoclonal band (CSF-OCB) was found in 14.6%. Our NMO patients had the average number of the attack of 1.5 times before the diagnosis could be made. Nearly fifty-five percent of NMO patients fulfilled the NMO diagnostic criteria 2006 within 1 year after disease onset and 90.5% within 5 years
Conclusion:
About half of Thai patients with definite NMO were diagnosed within 1 year and approximately 90% within 5 years from their disease onset.
