Progressive Myelopathy in a Patient with Pediatric Onset Neuromyelitis Optica Spectrum Disorder: A Case Report and a Mini Review.

Abstract

Purpose: Neuromyelitis optica is an autoimmune disease characterized mainly by the involvement of the spinal cord and optic nerve. Clinical studies have identified the disease progression as the most important red flag. Previous researches showed that only 2% of patients with neuromyelitis optica experience a progressive course. On the other hand, neuromyelitis optica is rarely occurred in children. In the present study a case of neuromyelitis optica was reported in a female who suffered from progressive myelopathy in the course of the disease.

Case report: The patient was a 30-year-old woman who has been affected to the disease at the age of 10 manifesting the quadriparesis. The patient also manifested optic neuritis twice. The disease became progressive at the age of 27. According to the results of the magnetic resonance imaging on spinal cord, severe atrophy was observed in the cervical and thoracic spine cord. The patient's antiaquaporin 4 antibody was positive.

Conclusion: Neuromyelitis optica is an astrocytopathy disease characterized by debilitating attacks. A very small percentage of patients may suffer a progressive course. According to the reported cases, this progressive course may be completely variable symptomatically, including progressive myelopathy, progressive vision impairments, and progressive cognitive impairment.