#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Differential diagnosis of neuromyelitis optica spectrum disorders


Authors: P. Nytrová
Authors‘ workplace: Neurologická klinika a Centrum klinických neurověd, 1. LF UK a VFN v Praze
Published in: Cesk Slov Neurol N 2020; 83/116(supplementum 1): 51-57
doi: https://doi.org/10.14735/amcsnn2020S51

Overview

Differential diagnosis of autoimmune CNS disorders is facilitated by the assessment of aquaporin-4 antibodies (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG-IgG). These autoantibodies are associated with neuromyelitis optica spectrum disorders (NMOSD) and MOG encephalomyelitis, respectively. Furthermore, these antibodies can confirm a considered diagnosis. The diagnosis of NMOSD can be based on clinical manifestation, e. g., severe optic neuritis and/or complete transverse myelitis. Nevertheless, the differential diagnosis of NMOSD is often challenging in incomplete transverse myelitis, brainstem symptoms, and optic neuritis with a good response to corticosteroid treatment. MRI findings and the absence of oligoclonal bands in cerebrospinal fluid can lead to a correct diagnosis. The most common disorders in the differential diagnosis for NMOSD are MS, ischemic lesions, and tumors.

Keywords:

MOG encephalomyelitis – neuromyelitis optica spectrum disorders


Sources

1. Lennon VA, Kryzer TJ, Pittock SJ et al. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 2005; 202 (4): 473–477. doi: 10.1084/jem.20050304.

2. Kitley J, Waters P, Woodhall M et al. Neuromyelitis optica spectrum disorders with aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies: a comparative study. JAMA Neurol 2014; 71 (3): 276–283. doi: 10.1001/jamaneurol.2013.5857.

3. Wingerchuk DM, Banwell B, Bennett JL et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 2015; 85 (2): 177–189. doi: 10.1212/WNL.0000000000001729.

4. Nytrová P, Kleinová P, Preiningerová Lízrová J et al. Neuromyelitis optica a poruchy jejího širšího spektra – retrospektivní analýza klinických a paraklinických nálezů. Cesk Slov Neurol N 2015; 78/111 (1): 72–77. doi: 10.14735/amcsnn201572

5. Nakamura M, Miyazawa I, Fujihara K et al. Preferential spinal central gray matter involvement in neuromyelitis optica: an MRI study. J Neurol 2008; 255: 163–170. doi: 10.1007/s00415-008-0545-z.

6. Jarius S, Paul F, Aktas O et al. MOG encephalomyelitis: international recommendations on diagnosis and antibody testing. J Neuroinflammation 2018; 15 (1): 134. doi: 10.1186/s12974-018-1144-2.

7. Dijindjian M, Djindjian R, Houdart R et al. Subarachnoid hemorrhage due to intraspinal tumors. Surg Neurol 1978; 9 (4): 223–229.

8. Carnero Contentti E, Leguizamón F, Hryb JP et al. Neuromyelitis optica: association with paroxysmal painful tonic spasms. Neuromielitis óptica: asociación con espasmos tónicos paroxísticos dolorosos. Neurologia 2016; 31 (8): 511–515. doi: 10.1016/j.nrl.2014.12.001.

9. Helfferich J, Knoester M, Van Leer-Buter CC et al. Acute flaccid myelitis and enterovirus D68: lessons from the past and present. Eur J Pediatr 2019; 178 (9): 1305–1315. doi: 10.1007/s00431-019-03435-3.

10. Jarius S, Paul F, Franciotta D et al. Cerebrospinal fluid findings in aquaporin-4 antibody positive neuromyelitis optica: results from 211 lumbar punctures. J Neurol Sci 2011; 306 (1–2): 82–90. doi: 10.1016/j.jns.2011.03.038.

11. Kim HJ, Paul F, Lana-Peixoto MA et al. MRI characteristics of neuromyelitis optica spectrum disorder: an international update. Neurology 2015; 84 (11): 1165–1173. doi: 10.1212/WNL.0000000000001367.

12. Pittock SJ, Lennon VA, de Seze J et al. Neuromyelitis optica and non organ-specific autoimmunity. Arch Neurol 2008; 65 (1): 78–83. doi: 10.1001/archneurol.2007.17.

13. Závada J, Nytrová P, Wandinger KP et al. Seroprevalence and specificity of NMO-IgG (anti-aquaporin 4 antibodies) in patients with neuropsychiatric systemic lupus erythematosus. Rheumatol Int 2013; 33 (1): 259–263. doi: 10.1007/s00296-011-2176-4.

14. Salvarani C, Brown RD Jr, Calamia KT et al. Primary CNS vasculitis with spinal cord involvement. Neurology 2008; 70 (24 Pt 2): 2394–2400. doi: 10.1212/01.wnl.0000314687.69681.24.

15. Yadav N, Pendharkar H, Kulkarni GB. Spinal cord infarction: clinical and radiological features. J Stroke Cerebrovasc Dis 2018; 27 (10): 2810–2821. doi: 10.1016/j.jstrokecerebrovasdis.2018.06.008.

16. Štětkářová et al. Spinální neurologie. In: Štěkářová I, Nytrová P. Autoimunitní myelitidy. Praha: Maxdorf 2019: 284–310

17. Kumral E, Polat F, Güllüoglu H et al. Spinal ischaemic stroke: clinical and radiological findings and short-term outcome. Eur J Neurol 2011; 18 (2): 232–239. doi: 10.1111/j.1468-1331.2010.02994.x.

18. Freedman BA, Malone DG, Rasmussen PA et al. Surfer‘s myelopathy: a rare form of spinal cord infarction in novice surfers: a systematic review. Neurosurgery 2016; 78 (5): 602–611. doi: 10.1227/NEU.0000000000001089.

19. Dillen WL, Hendricks BK, Mannas JP et al. Surfer‘s myelopathy: a rare presentation in a teenage gymnast and review of the literature. J Clin Neurosci 2018; 50: 157–160. doi: 10.1016/j.jocn.2018.01.039.

20. Schroeder GD, Vaccaro AR. Cervical spine injuries in the athlete. Instr Course Lect 2017; 66: 391–402.

21. Keřkovský M, Šprláková-Puková A, Bednařík J et al.Význam MR zobrazení difuze míchy v diferenciální dia¬gnostice míšních lézí. Cesk Slov Neurol N 2013; 76/109 (4): 477–481.

22. Miyakis S, Lockshin MD, Atsumi T et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4 (2): 295–306. doi: 10.1111/j.1538-7836.2006.01753.x.

23. Flanagan EP. Autoimmune myelopathies. HandbClin Neurol 2016; 133: 327–351. doi: 10.1016/B978-0-444-63432-0.00019-0.

24. Cavallieri F, Fini N, Contardi S et al. Subacute copper-deficiency myelopathy in a patient with occult celiac disease. J Spinal Cord Med 2017; 40 (4): 489–491. doi: 10.1080/10790268.2016.1246639.

25. Schwendimann RN. Metabolic and toxic myelopathies. Neurol Clin 2013; 31 (1): 207–218. doi: 10.1016/j.ncl.2012.09.002.

26. Weerasinghe D, Lueck C. Mimics and chameleons of optic neuritis. Pract Neurol 2016; 16 (2): 96–110. doi: 10.1136/practneurol-2015-001254.

27. Hickman SJ, Dalton CM, Miller DH et al. Management of acute optic neuritis. Lancet 2002; 360; 1953–1962. doi: 10.1016/s0140-6736 (02) 11919-2.

28. Chen JJ, Pittock SJ, Flanagan EP et al. Optic neuritis in the era of biomarkers. Surv Ophthalmol 2020; 65 (1): 12–17. doi: 10.1016/j.survophthal.2019.08.001.

29. Vanikieti K, Poonyathalang A, Jindahra P et al. Clinical characteristics and long-term visual outcome of optic neuritis in neuromyelitis optica spectrum disorder: a comparison between Thai and American-Caucasian cohorts. Mult Scler Relat Disord 2017; 17: 87–91. doi: 10.1016/j.msard.2017.07.013.

30. Zhao X, Qiu W, Zhang Y et al. A prospective case-control study comparing optical coherence tomography characteristics in neuromyelitis optica spectrum disorder – optic neuritis and idiopathic optic neuritis. BMC Ophthalmol 2018; 18 (1): 247. doi: 10.1186/s12886-018-0902-3.

31. Harding AE, Sweeney MG, Mil ler DH et al. Occurrence of a multiple sclerosis-like il lness in women whohave a Leber‘s hereditary optic neuropathy mitochondrial DNA mutation. Brain 1992; 115 (Pt 4): 979–989. doi: 10.1093/brain/115.4.979.

32. Kellar-Wood H, Robertson N, Govan GG et al. Leber’s hereditary optic neuropathy mitochondrial DNA mutations in multiple sclerosis. Ann Neurol 1994; 36 (1): 109–112. doi: 10.1002/ana.410360121.

33. Jansen PH, van der Knaap MS, de Coo IF. Leber‘s hereditary optic neuropathy with the 11,778 mtDNA mutationand white matter dis ease resembl ing multiple sclerosis: clinical, MRI and MRS fi ndings. J Neurol Sci 1996; 135 (2): 176–180. doi: 10.1016/0022-510x (95) 00287-c.

34. Petzold A, Plant GT. Chronic relapsing inflammatory optic neuropathy: a systematic review of 122 cases reported. J Neurol 2014; 261 (1): 17–26. doi: 10.1007/s00415-013-6957-4.

35. Wandinger KP, Stangel M, Witte T et al. Autoantibodies against aquaporin-4 in patients with neuropsychiatric systemic lupus erythematosus and primary Sjögren‘s syndrome. Arthritis Rheum 2010; 62 (4): 1198–1200. doi: 10.1002/art.27337.

36. Wang KC, Lee CL, Chen SY et al. Prominent brainstem symptoms/signs in patients with neuromyelitis optica in a Taiwanese population. J Clin Neurosci 2011; 18 (9): 1197–1200. doi: 10.1016/j.jocn.2010.12.052.

37. Shosha E, Dubey D, Palace J et al. Area postrema syndrome: frequency, criteria, and severity in AQP4-IgG-positive NMOSD. Neurology 2018; 91 (17): e1642–e1651. doi: 10.1212/WNL.0000000000006392.

Labels
Paediatric neurology Neurosurgery Neurology
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#