Very short multifocal myelitis lesions as initial signs of neuromyelitis optica spectrum disorder
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LETTER TO THE EDITOR
Very short multifocal myelitis lesions as initial signs of neuromyelitis optica spectrum disorder Jung Im Seok1 · Min Su Park2 Received: 15 April 2019 / Accepted: 2 July 2019 © Belgian Neurological Society 2019
Keywords Neuromyelitis optica · Magnetic resonance imaging · Myelitis · Aquaporin 4 Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory, demyelinating disease of the central nervous system that is characterized by severe attacks of optic neuritis and myelitis [1]. Because 80–90% of patients with NMOSD experience relapsing episodes of optic neuritis and myelitis, early diagnosis and maintenance immunosuppressive therapy are important for preventing relapse. Although longitudinally extensive transverse myelitis (LETM), which is defined as myelitis extending over ≥ 3 vertebrae in magnetic resonance imaging (MRI) scans, is an NMOSD-specific radiologic finding, patients with NMOSD may also present with short transverse myelitis (STM). However, very short myelitis occupying less than half of a segment is extremely rare in NMOSD. A 41-year-old Korean woman presented with a 3-month history of a tingling sensation and allodynia in her lower torso. A neurologic examination revealed left-side hyperesthesia below the T7 dermatome. No abnormalities were found in laboratory evaluation. Spinal MRI scans revealed two spinal cord lesions at the centroposterior portion of the T2 vertebra and the left eccentric portion of the T9 vertebra (Fig. 1). Cerebrospinal fluid analysis revealed a slightly elevated protein level (67 mg/dL; normal range,
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