Neuromyelitis optica spectrum disorder mimicking multiple sclerosis

Area of Science:

• Neurology
• Immunology
• Neuroimmunology

Background:

• Multiple sclerosis (MS) is a central nervous system demyelinating disease with characteristic clinical and radiological presentations.
• Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune condition triggered by antibodies, often causing severe myelitis and optic neuritis.

Observation:

• A 29-year-old woman presented with a clinical and radiological profile typical of relapsing-remitting MS.
• She developed longitudinally extensive transverse myelitis (LETM), a condition not typically associated with MS.

Findings:

• The patient tested positive for aquaporin-4 antibodies.
• These findings fulfilled the diagnostic criteria for NMOSD, despite the initial presentation resembling MS.

Implications:

• LETM in a patient with MS-like symptoms warrants consideration of NMOSD.
• Testing for aquaporin-4 antibodies is critical for differentiating NMOSD from MS, impacting treatment strategies.