DR. KIRTI CHHABRA

DR. DEVENDRA KUMAR SHAKYA, DR. DIVYA RANA

Abstract

Neuromyelitis optica (Devic’s syndrome) is a rare ,autoimmune, inflammatory demyelinating disease of the central nervous system that predominantly affects the spinal cord and optic nerves and usually mimics multiple sclerosis. We describe a 23-year-old male who had 8 months history of unilateral loss of vision associated with periorbital pain on right side,generalized weakness and numbness of limbs and urinary incontinence.MRI brain revealed no significant abnormality. It was diagnosed by Fundus examination suggestive of Right eye optic neuritis, characteristic MRI spine with longitudinally extensive transverse myelitis and positive NMO specific Aquaporin4-IgG. His symptoms resolved partially with IV steroids but his vision deteriorated gradually after the steroids were tapered,following which immunosuppressant (azathioprine) was added. Early discrimination between NMO and Multiple sclerosis is important because of their different natural histories,treatment regimens and prognosis.