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Neurology. 2015 Mar 17;84(11):1165-73. doi: 10.1212/WNL.0000000000001367. Epub 2015 Feb 18.

MRI characteristics of neuromyelitis optica spectrum disorder: an international update.

Author information

1
From the Department of Neurology (H.J.K., S.-H.K.), Research Institute and Hospital of National Cancer Center, Goyang, Korea; NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center (F.P., J.W.), Department of Neurology, Charité University Medicine, Berlin, Germany; CIEM MS Research Center (M.A.L.-P.), Federal University of Minas Gerais Medical School, Belo Horizonte, Brazil; Department of Neurology (S.T.), National Paediatric Hospital Dr. Juan P. Garrahan, Buenos Aires, Argentina; Neurobiology (N.A.), Institute of Molecular Medicine, University of Southern Denmark; Department of Neurology (N.A.), Vejle Hospital, Denmark; Department of Clinical Neurology (J.P.), John Radcliffe Hospital, Oxford, UK; Department of Neurology, Massachusetts General Hospital (E.C.K.), Harvard Medical School, Boston, MA; Department of Neurology (D.K.S.), Tohoku University School of Medicine, Sendai, Japan; Neurology Department (J.d.S.), Hôpitaux Universitaires de Strasbourg, France; Institute of Neuroradiology (J.W.), University Medicine Goettingen, Germany; Department of Pediatrics (B.L.B.), Division of Neurology, The Children's Hospital of Philadelphia; Department of Neurology (B.L.B.), The University of Pennsylvania; Center of Neuroimmunology (P.V., A.S.), Service of Neurology, Hospital Clinic and Institute of Biomedical Research August Pi Sunyer, Barcelona, Spain; and Department of Multiple Sclerosis Therapeutics (K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan. hojinkim@ncc.re.kr.
2
From the Department of Neurology (H.J.K., S.-H.K.), Research Institute and Hospital of National Cancer Center, Goyang, Korea; NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center (F.P., J.W.), Department of Neurology, Charité University Medicine, Berlin, Germany; CIEM MS Research Center (M.A.L.-P.), Federal University of Minas Gerais Medical School, Belo Horizonte, Brazil; Department of Neurology (S.T.), National Paediatric Hospital Dr. Juan P. Garrahan, Buenos Aires, Argentina; Neurobiology (N.A.), Institute of Molecular Medicine, University of Southern Denmark; Department of Neurology (N.A.), Vejle Hospital, Denmark; Department of Clinical Neurology (J.P.), John Radcliffe Hospital, Oxford, UK; Department of Neurology, Massachusetts General Hospital (E.C.K.), Harvard Medical School, Boston, MA; Department of Neurology (D.K.S.), Tohoku University School of Medicine, Sendai, Japan; Neurology Department (J.d.S.), Hôpitaux Universitaires de Strasbourg, France; Institute of Neuroradiology (J.W.), University Medicine Goettingen, Germany; Department of Pediatrics (B.L.B.), Division of Neurology, The Children's Hospital of Philadelphia; Department of Neurology (B.L.B.), The University of Pennsylvania; Center of Neuroimmunology (P.V., A.S.), Service of Neurology, Hospital Clinic and Institute of Biomedical Research August Pi Sunyer, Barcelona, Spain; and Department of Multiple Sclerosis Therapeutics (K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan.

Abstract

Since its initial reports in the 19th century, neuromyelitis optica (NMO) had been thought to involve only the optic nerves and spinal cord. However, the discovery of highly specific anti-aquaporin-4 antibody diagnostic biomarker for NMO enabled recognition of more diverse clinical spectrum of manifestations. Brain MRI abnormalities in patients seropositive for anti-aquaporin-4 antibody are common and some may be relatively unique by virtue of localization and configuration. Some seropositive patients present with brain involvement during their first attack and/or continue to relapse in the same location without optic nerve and spinal cord involvement. Thus, characteristics of brain abnormalities in such patients have become of increased interest. In this regard, MRI has an increasingly important role in the differential diagnosis of NMO and its spectrum disorder (NMOSD), particularly from multiple sclerosis. Differentiating these conditions is of prime importance because early initiation of effective immunosuppressive therapy is the key to preventing attack-related disability in NMOSD, whereas some disease-modifying drugs for multiple sclerosis may exacerbate the disease. Therefore, identifying the MRI features suggestive of NMOSD has diagnostic and prognostic implications. We herein review the brain, optic nerve, and spinal cord MRI findings of NMOSD.

PMID:
25695963
PMCID:
PMC4371410
DOI:
10.1212/WNL.0000000000001367
[Indexed for MEDLINE]
Free PMC Article
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