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Boundary between multiple sclerosis and neuromyelitis optica
Author(s) -
Nakashima Ichiro
Publication year - 2017
Publication title -
clinical and experimental neuroimmunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.297
H-Index - 15
ISSN - 1759-1961
DOI - 10.1111/cen3.12348
Subject(s) - neuromyelitis optica , multiple sclerosis , medicine , myelin oligodendrocyte glycoprotein , optic neuritis , aquaporin 4 , myelitis , spectrum disorder , myelin , magnetic resonance imaging , pathology , fingolimod , expanded disability status scale , spinal cord , central nervous system , immunology , experimental autoimmune encephalomyelitis , radiology , psychiatry
Multiple sclerosis and neuromyelitis optica spectrum disorders are often indistinguishable by their clinical features. Recently, anti‐myelin oligodendrocyte glycoprotein antibody was found in the serum of neuromyelitis optica spectrum disorders patients without anti‐aquaporin‐4 antibody. This finding suggests a new category of central nervous system demyelinating diseases. However, even with the information provided by these serum antibody results, the diagnoses of some patients remain problematic. In the present article, a case that appeared to be at the boundary between multiple sclerosis and neuromyelitis optica are presented. The patient was a 41‐year‐old woman who developed relapsing myelitis. Spinal cord magnetic resonance imaging showed a relatively long lesion. She had not developed brain lesions on routine magnetic resonance imaging for more than 5 years. She was negative for anti‐aquaporin‐4 antibody, and oral prednisolone could not prevent her relapses. However after fingolimod administration, she became stable and Expanded Disability Status Scale gradually improved.