H-Index
17
Scimago Lab
powered by Scopus
eISSN: 1941-5923
call: +1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Logo

MSMbanner
Medical Science Monitor Basic Research

Annals
ISI-Home

Seronegative Neuromyelitis Optica Spectrum Disorder: An Unusual Presentation of Acute Brainstem Syndrome

Unusual clinical course

Zahra Haider Alshurafa, Mashael Omar Alkhateeb

Saudi Arabia College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

Am J Case Rep 2020; 21:e922590

DOI: 10.12659/AJCR.922590

Available online: 2020-04-02

Published: 2020-05-04


#922590

BACKGROUND: Neuromyelitis optica (NMO) is an autoimmune, demyelinating, inflammatory disorder affecting the central nervous system, mostly targeting optic nerves and the spinal cord. NMO spectrum disorder (NMOSD) is a newly revised nomenclature in which new diagnostic criteria have been developed, including serological testing of serum aquaporin-4 immunoglobulin G (AQP4-IgG) antibodies. Results of a negative antibody will group the patient in a seronegative subgroup.
CASE REPORT: We describe the case of a 27-year-old female who presented to our hospital with new onset of sudden unexplained vomiting, dysphagia, dysphonia, and food regurgitation. Extensive investigations were done and brain magnetic resonance imaging (MRI) showed a small nonspecific area of signal abnormality in the right dorsal medulla. Aquaporin-4 antibodies were negative, and the patient was diagnosed with seronegative NMOSD with acute brainstem syndrome after meeting the diagnostic criteria. The patient’s condition improved after steroids administration.
CONCLUSIONS: We report an unusual presentation of seronegative NMOSD presenting with acute brainstem syndrome.

Keywords: Aquaporin 4, Brain Stem, dysphonia, Neuromyelitis Optica, Vomiting



Back