Table 2.
Case #1.
| A 39-year-old woman with one prior optic neuritis in the right eye (confirmed by an ophthalmologist) and one prior myelitis event with moderate residual weakness of the right leg. Currently, she consults for severe weakness in both legs associated with sphincter disorders that was confirmed by the neurologist during examination. No other sign and symptoms. Brain and spinal cord MRI: Brain MRI does not reveal any new T2 or enlarging gadolinium enhancing lesions. Cervical and thoracic spinal cord MRI show a new thoracic T2 lesion extending from T1 to T8 with gadolinium enhancement from T3 to T5. | |
|
What is your opinion?, n (%)
These findings are commonly seen in MS patients These findings are commonly seen in patients with NMOSD seropositive for AQP4-Ab These clinical manifestations are commonly seen in patients with NMOSD, but not the MRI findings These clinical manifestations are not commonly seen in patients with NMOSD, but spinal MRI lesion is typically seen in NMOSD. |
0 104 (98.1) 0 2 (1.9) |
|
Does this patient’s presentation fulfill dissemination in space criteria for a diagnosis of NMOSD?, n (%)
Yes No Not reported |
95 (89.6) 2 (1.8) 9 (8.6) |
|
If a history of optic neuritis would not have been present, but visual evoked potential of the right eye was prolonged despite absence of clinical symptoms in that eye, would criteria for NMOSD diagnosis been satisfied?, n (%)
No Yes Do not know Not reported |
54 (50.9) 44 (41.5) 5 (4.9) 3 (2.7) |
|
Based on the data above, does this patient meet diagnostic criteria for NMOSD if seronegative for AQP4-IgG?, n (%)
No, this patient does not have a core clinical characteristic of NMOSD. No, although this patient presents with a core clinical characteristic for NMOSD, the patient is AQP4-IgG seronegative. Yes, this patient presents with a core clinical characteristic for NMOSD, and history of other core clinical characteristics and has the necessary supportive MRI finding of an acute longitudinally extensive spinal cord lesion thus meeting dissemination in space criteria assuming that no better explanation exists even with AQP4-Ab negative/unknown. No, this patient presents with a core clinical characteristic for NMOSD, but dissemination in space and dissemination in time criteria are not fulfilled, and therefore, the patient has no NMOSD. |
2 (1.8) 2 (1.8) 101 (95.5) 1 (0.9) |
Correct answers are shown in bold.