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Published on: August 21, 2017
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Neuromyelitis optica with unilateral diaphragmatic paralysis
Sami Bennji1, Diaeddin Sagar2, Naeem Brey3
1Department of Medicine, Stellenbosch University, Cape Town, South Africa.
BMJ Case Reports
|October 1, 2018
Summary
Neuromyelitis optica (NMO) can cause severe neurological deficits like hemiparesis and diaphragmatic paralysis. Plasmapheresis showed partial improvement, but phrenic nerve palsy persisted in this patient.
Area of Science:
- Neurology
- Neuroimmunology
Background:
- Neuromyelitis optica (NMO) is a severe autoimmune disease targeting the central nervous system.
- NMO spectrum disorders can present with diverse and debilitating neurological symptoms.
Observation:
- A female patient with a history of neuromyelitis optica (NMO) presented with acute left hemiparesis and unilateral diaphragmatic paralysis.
- Initial treatment with intravenous methylprednisolone yielded no significant improvement.
Findings:
- Subsequent treatment with five sessions of plasmapheresis led to improvement in hemiparesis.
- Phrenic nerve palsy, a critical complication affecting breathing, showed limited response to plasmapheresis.
Implications:
- This case highlights the variable treatment response in NMO, particularly for respiratory complications.
- It underscores the need for tailored therapeutic strategies for NMO patients with severe neurological involvement.
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