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Dorsal midbrain involvement in MRI as a core clinical manifestation for NMOSD diagnosis
Masoud Etemadifar1, Fatemeh Sabeti2, Shadi Ebrahimian3
1Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
Background:
Few data are available on the prevalence of midbrain lesions among NMOSD patients. The study aimed to address the frequency of midbrain lesions, especially dorsal midbrain involvement, among a group of NMOSD patients.
Methods:
The medical records of 108 NMOSD patients were reviewed, who were registered at the Al-Zahra MS Clinic, Isfahan, Iran. The patients´ information including sex, age, first recorded chief complaint, and midbrain lesion presence in the first brain MRI was collected.
Results:
Out of the 108 NMOSD patients, eight had midbrain lesions in their first brain MRI (7.4%). Of these patients, 50% were male and 50% were female, with the mean age being 35.25 ± 12.17 years. The most frequent first chief complaints included diplopia due to incomplete third nerve palsy and vertigo. The brain MRIs of the patients showed symmetric dorsal midbrain involvement in all the patients, and enhancement was discovered in only one of the brain MRIs.
Conclusion:
Among the patients, 7.4% presented midbrain involvement at onset. Therefore, midbrain lesions should also be considered as a possible core clinical manifestation in the NMOSD diagnostic criteria.
Insights
Midbrain lesions occur in 7.4% of patients with Neuromyelitis Optica Spectrum Disorder (NMOSD) at onset. Dorsal midbrain involvement is common, suggesting these lesions are a key NMOSD manifestation.
Area of Science:
- Neurology
- Neuroimmunology
- Radiology
Background:
- Limited data exists on midbrain lesion prevalence in Neuromyelitis Optica Spectrum Disorder (NMOSD).
- Dorsal midbrain involvement is a specific area of interest within NMOSD pathology.
Purpose of the Study:
- To determine the frequency of midbrain lesions in NMOSD patients.
- To investigate the characteristics of midbrain lesions, particularly dorsal involvement, in NMOSD.
Main Methods:
- Retrospective review of 108 NMOSD patients' medical records from Isfahan, Iran.
- Collection of demographic data, chief complaints, and first brain MRI findings, focusing on midbrain lesions.
Main Results:
- Midbrain lesions were identified in 7.4% (8/108) of NMOSD patients on initial MRI.
- Affected patients (50% male/50% female, mean age 35.25) presented with symptoms like diplopia and vertigo.
- All identified lesions showed symmetric dorsal midbrain involvement; only one exhibited enhancement.
Conclusions:
- Midbrain involvement is present in 7.4% of NMOSD patients at disease onset.
- The findings support considering midbrain lesions as a core clinical manifestation in NMOSD diagnostic criteria.
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