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  • Title: [Devic's neuromyelitis optica: diagnosis after 10 years of bilateral severe relapsing optic neuritis].
    Author: Déral-Stéphant V, Roux-Lelièvre C, Vignal R, Stéphant E, Faivre A, Alla P.
    Journal: J Fr Ophtalmol; 2008 Sep; 31(7):705-9. PubMed ID: 18971856.
    Abstract:
    INTRODUCTION: Neuromyelitis optica, also known as Devic's disease, is a severe idiopathic inflammatory demyelinating disease of the central nervous system that preferentially affects the optic nerve and spinal cord. Neuromyelitis optica has long been thought of as a variant of multiple sclerosis; however, clinical, laboratory, immunological, and pathological characteristics that distinguish it from multiple sclerosis have now been recognized. CASE REPORT: A young man presented isolated severe bilateral relapsing optic neuritis. After having evolved over 10 years, the appearance of multiple sclerosis-like lesions on the brain led to the diagnosis of multiple sclerosis. Acute myelitis and the presence of NMO-IgG antibodies in the serum finally led to the diagnosis of neuromyelitis optica. CONCLUSION: This case is an illustration of the new criteria in the diagnosis of NMO, underscoring the importance of the positive serum NMO-Ig G antibody to distinguish multiple sclerosis from NMO. It also emphasizes that asymptomatic brain lesions are common in NMO on brain MRIs and symptomatic brain lesions do not exclude its diagnosis.
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