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Cervical neuromyelitis optica with thoracic ependymoma
Yeow Leng Tan1, Minghe Moses Koh2
1Department of Rehabilitation Medicine, Singapore General Hospital, Singapore.
Surgical Neurology International
|September 13, 2021
Summary
Spinal ependymoma patients may develop neuromyelitis optica (NMO), a rare autoimmune disorder. Early diagnosis and treatment are crucial for managing these co-occurring neurological conditions.
Area of Science:
- Neurology
- Neuro-oncology
- Autoimmunology
Background:
- Neuromyelitis Optica (NMO) is a rare autoimmune disorder affecting the central nervous system.
- Spinal ependymomas are tumors that develop in the spinal cord.
- The co-occurrence of cervical NMO and thoracic ependymoma is exceptionally rare.
Observation:
- A 66-year-old male with a T2-T4 intramedullary ependymoma presented with right lower limb weakness.
- Two months post-surgery, the patient developed acute quadriparesis and a C2-C3 spinal cord lesion.
- Diagnostic studies confirmed seropositive Neuromyelitis Optica (NMO).
Findings:
- Intramedullary thoracic ependymomas can be associated with the development of NMO.
- NMO onset can lead to recurrent or new neurological deficits in these patients.
- Diagnostic criteria for NMO include specific MRI findings, AQP4-IgG serology, and visual evoked potentials.
Implications:
- Prompt diagnosis and management of NMO are essential in patients with spinal ependymomas.
- Comprehensive diagnostic workup including advanced imaging and serological tests is critical.
- Multimodal treatment strategies are necessary for patients diagnosed with both conditions.
