Figure 1.

Select MRI brain and spinal cord images and optical coherence tomography in patients with prodromal neurologic symptoms preceding a diagnosis of AQP4-IgG-positive NMOSD. 1: Case 1, patient with severe right-sided headache and left torso and leg sensory symptoms. (1.a) Axial and (1.b) Sagittal T2 FLAIR show a T2 hyperintense lesion in the right parietal white matter, sparing the cortex. 2: Case 10, patient with prodromal Lhermitte sign and asymptomatic optic disc oedema. (2.a) Axial and (2.b) Sagittal T2 FLAIR at the time of the first NMOSD attack reveal T2 hyperintense lesions in the left cerebral peduncle and splenium of the corpus collosum. (2.c) Optical coherence tomography after asymptomatic left optic disc oedema shows retinal ganglion cell layer thinning in the left eye. 3: Case 11, patient with left inferior quadrantopia. (3.a) Axial T2 FLAIR and (3.b) Axial T1 post-contrast at the time of prodromal neurologic symptoms show a right occipital periventricular lesion with subtle patchy enhancement. (2.c) Diffusion weighted imaging and (2.d) Apparent diffusion coefficient show partial diffusion restriction.

OD: right eye; OS: left eye; RNFL: retinal nerve fibre layer; GCL: ganglion cell layer; IPL: inner plexiform layer.