Acute cervical segmental denervation in neuromyelitis optica spectrum disorder

摘要

Objectives: Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of central nervous system. We report a case of NMO spectrum disorder that developed acute cervical segmental denervation during an episode of transverse myelitis. Methods: Case report and a literature review.Results: A 69-year-old woman presented with right leg weakness, which improved in 2 weeks of intravenous methylprednisolone. Six weeks later, she returned with recurrent transverse myelitis followed by left hand weakness and atrophy. Electromyography showed active denervation on left C8/T1-innervated muscles. Magnetic resonance imaging of thoracic spine showed patchy T2-signal enhancement from T10 to lower cervical spine. NMO antibody was positive. Review of literature revealed 5 cases of cervical transverse myelitis that developed denervation on electromyography.Conclusions: Segmental denervation may occur in NMO and variants resulting from severe myelitis extending to involve gray and white matter leads to anterior horn cell loss.