Neuromyelitis optica spectrum disorder mimicking stroke: A case report and literature review

J Neuroimmunol. 2023 Dec 15:385:578223. doi: 10.1016/j.jneuroim.2023.578223. Epub 2023 Oct 24.

Abstract

Hemiparesis is a frequently observed manifestation of stroke but exceptionally rare in the context of neuromyelitis optica spectrum disorder (NMOSD). In this case, a 68-year-old woman initially presented with acute right-sided weakness, leading to suspicion of ischemic stroke. However, her symptoms worsened despite treatment with aspirin and statins. Subsequent spinal MRI and aquaporin 4 antibody testing confirmed the diagnosis of NMOSD. The administration of methylprednisolone and immunoglobulin resulted in improved clinical outcomes. This case serves as an illustrative example of the diverse manifestations encountered in NMOSD and underscores the significance of considering this potential etiology in elderly patients to facilitate prompt diagnosis and therapeutic intervention.

Keywords: Hemiparesis; Neuromyelitis optica spectrum disorder; Stroke.

Publication types

  • Review
  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aquaporin 4
  • Aspirin / therapeutic use
  • Autoantibodies
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Methylprednisolone / therapeutic use
  • Neuromyelitis Optica* / diagnostic imaging
  • Neuromyelitis Optica* / drug therapy
  • Stroke* / diagnostic imaging
  • Stroke* / drug therapy

Substances

  • Aquaporin 4
  • Aspirin
  • Autoantibodies
  • Methylprednisolone