Annals of medicine and surgery (2012) · 2025
Neuromyelitis optica - a cause for longitudinally extensive transverse myelitis: a rare case report from Nepal and literature review.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sah Ujwal, Tripathi Amrit, Shah Saurav, Poudel Sishir, Bhardwaj Aaditya, Jha Ayush, Mishra Aryan, Yadav Arun Kumar, Nishad Surya Raj
Аннотация
INTRODUCTION: Neuromyelitis optica is a rare autoimmune condition, which is manifested by inflammation of optic nerve (optic neuritis) and spinal cord (myelitis). Longitudinally extensive transverse myelitis (LETM) is a neurological disorder leading to contiguous inflammatory spinal cord lesion, seen as T2 hyperintensity that extends over three or more vertebral segments on MRI of spine. Here, the author presents a case report on LETM from Western Nepal.
CASE PRESENTATION: The author reports a case of 21-year-female with no known comorbidities who presented to neuro OPD with complaint of progressive bilateral lower limb weakness for 2 weeks, associated with bowel and bladder incontinence for 3 days. There is no significant past or family history.
DISCUSSION: A detailed history, clinical examination, radiological findings, and interventions like lumbar puncture, MRI is critical to intervene for the cause of LETM. Treatment of patient depends upon underlying etiologies. In this case, patient is managed by IV methylprednisolone. Regular assessment and evaluation help in determining the prognosis of patient.
CONCLUSION: Neuromyelitis optica spectrum disorder (NMOSD), being more common in middle-aged group (30-45 years); can occur in younger age group as per our case. Specialized AQP4 detection is often constrained in many parts of Nepal which is a big challenge, especially in resource-limited settings. This case highlights that positive AQP4 testing helps in reaching a definitive diagnosis and timely initiation of high-dose steroids and immunosuppressive therapy that brings out substantial recovery at 2 months - consistent with literature showing that early aggressive therapy prompts to better outcomes.
CASE PRESENTATION: The author reports a case of 21-year-female with no known comorbidities who presented to neuro OPD with complaint of progressive bilateral lower limb weakness for 2 weeks, associated with bowel and bladder incontinence for 3 days. There is no significant past or family history.
DISCUSSION: A detailed history, clinical examination, radiological findings, and interventions like lumbar puncture, MRI is critical to intervene for the cause of LETM. Treatment of patient depends upon underlying etiologies. In this case, patient is managed by IV methylprednisolone. Regular assessment and evaluation help in determining the prognosis of patient.
CONCLUSION: Neuromyelitis optica spectrum disorder (NMOSD), being more common in middle-aged group (30-45 years); can occur in younger age group as per our case. Specialized AQP4 detection is often constrained in many parts of Nepal which is a big challenge, especially in resource-limited settings. This case highlights that positive AQP4 testing helps in reaching a definitive diagnosis and timely initiation of high-dose steroids and immunosuppressive therapy that brings out substantial recovery at 2 months - consistent with literature showing that early aggressive therapy prompts to better outcomes.