The Diagnosis of Neuromyelitis Optica by Biopsy in a Patient with Long Spinal Cord Lesion: A Case Report

Neuromyelitis Optica Spectrum Diseases (NMOSD) is an inflammatory demyelinating disease, which is characterized by recurrent optic neuritis, longitudinal long-segment transverse myelitis attacks and Aquaporin-4 antibody positivity. Except NMOSD, long-segment longitudinal transverse myelitis can be also detected in systemic autoimmune diseases, spinal cord tumors, spinal vascular pathologies, Early detection and treatment of NMOSD is very important as the disease may cause severe disability in young population. A 23-year-old female patient was admitted to our clinic with acute paraplegia and urine incontinence. Spinal Magnetic Resonance Imaging showed a densly edematose, contrast enhanced lesion longitudinally extending between C7 and T7 in the spinal cord. As the lesion was reported to be an astrocytoma, a biopsy was performed. However, pathological stainings revelaed no tumor. NMOSD was verified later with Aquaporin-4 positivity. Although longitudinally extending spinal cord lesions are not rare in NMOSD, our patient’s lesion was very edematose and longer than expected that deserved reporting.