Neuromyelitis Optica Disorders: A Retrospective Observational Study: Experience of Tertiary Hospital in Central India

Priyanka V Kashyap; Sounak Chabri; Anshul Singh; Arpit Dhiren; Akanxa Yadav

Abstract

Background: NMOSD is a wide spectrum primary demyelinating syndrome of nervous system with varied clinical, serology and radiologic features. Objectives: We aim to study the vividness of clinical, serological and associated radiologic features of this disorder through retrospective analysis of the patients’ parameters presented to Neurology unit of AIIMS, Bhopal. Methods: It is a retrospective observational study from July 2020 till July 2022 in neurology. Results: 36 patients were assessed; of which, 18 patients suffice multiple sclerosis (MS) group, 10 patients in neuromyelitis optica (NMO) group and 2 and 6 patients in myelin oligodendrocyte glycoprotein antibody (MOGAD) and other unclassified demyelinating group respectively. Female predominance was most evident in NMO, followed by MS group. Duration of illness was shortest in MOGAD group (18.5±24.74 months) Extended Disability Status Scale (EDSS) was least in the MOGAD group (1.5). Bladder dysfunction associated with transverse myelitis (TM) was present in 80% in NMO group, and in 77.7% in MS group. Unilateral optic neuritis (ON) was commonest in MS group (27.77%) than NMO group (10%) but bilateral ON was most seen in MOGAD. Bilateral ON was seen in 11% of MS. Area postrema syndrome (APS) were noted in 30% of NMO patients. Imaging features were unique in MS (juxtacortical and cerebellar). Short segment myelitis was more common with MS group (66.67%) and conus involved in 50% of MOGAD group. Aquaporin antibody and MOG antibody were positive in all patients of the NMO and MOG group, 88.89% of MS patients had cerebrospinal fluid (CSF) oligoclonal band (OCB) positive. Conclusion: NMOSD has distinct features, radiologic and serum biomarkers that help to subgroup it.

Abstract

Keywords