Neuromyelitis optica with brainstem lesion mistaken for brainstem glioma

Case report

Keun Young Park Department of Neurosurgery, Brain Research Institute, and

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 M.D.
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Jung Yong Ahn Department of Neurosurgery, Brain Research Institute, and

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 M.D., Ph.D.
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Jun Hyung Cho Department of Neurosurgery, Brain Research Institute, and

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Young Chul Choi Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea

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Kyu Sung Lee Department of Neurosurgery, Brain Research Institute, and

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 M.D., Ph.D.
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✓Neuromyelitis optica (NMO) is a severe demyelinating syndrome defined principally by its tendency to affect optic nerves and the spinal cord selectively. Asymptomatic brain lesions have recently become a common finding in NMO, and symptomatic brain lesions do not exclude the diagnosis of this entity. The authors describe the case of a 12-year-old girl suffering from an unusually atypical form of NMO in which a brainstem lesion was mistaken for a brainstem glioma. Brainstem involvement in NMO exhibits variable features on neuroimaging and is confused with brainstem glioma in cases of extensive brainstem involvement in childhood. Careful differential diagnosis and proper treatment are vital for a favorable prognosis.

Abbreviations used in this paper:

CSF = cerebrospinal fluid; IgG = immunoglobulin G; MR = magnetic resonance; MS = multiple sclerosis; NAA = N-acetylaspartate; NMO = neuromyelitis optica.
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  • 1

    Bakker J, & Metz L: Devic's neuromyelitis optica treated with intravenous gamma globulin. Can J Neurol Sci 31:265267, 2004

  • 2

    Chalumeau-Lemoine L, , Chretien F, , Gaëlle Si Larbi A, , Brugieres P, , Gray F, & Brun-Buisson C, et al.: Devic disease with brainstem lesions. Arch Neurol 63:591593, 2006

  • 3

    Cree BAC, , Lamb S, , Morgan K, , Chen A, , Waubant E, & Genain C: An open label study of the effects of rituximab in neuromyelitis optica. Neurology 64:12701272, 2005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Curless RG, , Bowen BC, , Pattany PM, , Gonik R, & Kramer DL: Magnetic resonance spectroscopy in childhood brainstem tumors. Pediatr Neurol 26:374378, 2002

  • 5

    Gonzalez-Toledo E, , Kelley RE, & Minagar A: Role of magnetic resonance spectroscopy in diagnosis and management of multiple sclerosis. Neurol Res 28:280283, 2006

  • 6

    Keegan M, , Pineda AA, , McClelland RL, , Darby CH, , Rodriguez M, & Weinshenker BG: Plasma exchange for severe attacks of CNS demyelination: predictors of response. Neurology 58:143146, 2002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Lennon VA, , Wingerchuk DM, , Kryzer TJ, , Pittock SJ, , Lucchinetti CF, & Fujihara K, et al.: A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 364:21062112, 2004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Mandler RN, , Ahmed W, & Dencoff JE: Devic's neuromyelitis optica: a prospective study of seven patients treated with prednisone and azathioprine. Neurology 51:12191220, 1998

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Möller-Hartmann W, , Herminghaus S, , Krings T, , Marquardt G, , Lanfermann H, & Pilatus U, et al.: Clinical application of proton magnetic resonance spectroscopy in the diagnosis of intracranial mass lesions. Neuroradiology 44:371381, 2002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Pittock SJ, , Lennon VA, , Krecke K, , Wingerchuk DM, , Lucchinetti CF, & Weinshenker BG: Brain abnormalities in neuromyelitis optica. Arch Neurol 63:390396, 2006

  • 11

    Porto L, , Hattingen E, , Pilatus U, , Kieslich M, , Yan B, & Schwabe D, et al.: Proton magnetic resonance spectroscopy in childhood brainstem lesions. Childs Nerv Syst 23:305314, 2007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Weinshenker BG: Neuromyelitis optica: what it is and what it might be. Lancet 361:889890, 2003

  • 13

    Weinshenker BG, , Wingerchuk DM, , Vukusic S, , Linbo L, , Pittock SJ, & Lucchinetti CF, et al.: Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis. Ann Neurol 59:566569, 2006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Wingerchuk DM, , Hogancamp WF, , O'Brien PC, & Weinshenker BG: The clinical course of neuromyelitis optica (Devic's syndrome). Neurology 53:11071114, 1999

  • 15

    Wingerchuk DM, , Lennon VA, , Pittock SJ, , Lucchinetti CF, & Weinshenker BG: Revised diagnostic criteria for neuromyelitis optica. Neurology 66:14851489, 2006

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