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February 2013

What Is the True Clinicopathologic Spectrum of Neuromyelitis Optica?

Author Affiliations

Author Affiliations: Cleveland Clinic Florida, Weston, Florida.

JAMA Neurol. 2013;70(2):272-273. doi:10.1001/jamaneurol.2013.963

We read with interest the article by Mealy at al1 on the clinicopathologic spectrum of neuromyelitis optica (NMO)/NMO spectrum disorder. We have the following additional comments on the NMO spectrum:

A 42-year old woman presented with sudden-onset urinary retention that rapidly progressed to a flaccid paraplegia. Results of imaging studies were negative initially; repeat magnetic resonance imaging 5 days from symptom onset revealed conus myeloradiculitis. Results from extensive testing, including spinal angiogram as well as testing for NMO antibodies and visual evoked potentials, were negative. Results from repeat NMO antibody testing 1 year from the initial symptom onset were positive. Few reports have described conus involvement with NMO2; root involvement with NMO is even more rarely described. There are no cases in the current series where there is conus involvement or root involvement.

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