In reply
We appreciate the comments of Drs Govindarajan and Salgado relative to our article about the clinicopathologic spectrum of neuromyelitis optica (NMO)/NMO spectrum disorder. They point out 2 other potential clinical manifestations of NMO and question the conclusions relative to natalizumab and interferon therapy.
The cases presented do indeed represent potential presentations for NMO. The first case describes a patient who presented with clinical and radiographic evidence of myeloradiculitis and whose test results were subsequently found to be positive for the anti–aquaporin 4 (AQP4) antibody. The second case involves a patient with generalized pruritus preceding myelitis and whose test results were positive for anti-AQP4 antibody. While our case series did not specifically record these patient types, it is worth noting 2 observations.