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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | NMO (Neuromyelitis Optica) | NMO | 2A0 Case 2 History
Case 2 History ---- The patient was a 78 year old woman with a history of neuromyelitis optica (NMO) with transverse myelitis (at least two attacks), and positive NMO-IgG antibodies. Her symptoms began in 1988, with abdominal "burning" sensations. Other symptoms have included episodes of vertigo, extreme tiredness, and lower extremity weakness. She has had a relapsing/remitting course with more than 17 exacerbations noted. MRI in 1988 showed thoracic spine "diffuse edema", and MRI in 1990 was reportedly normal. She was wheelchair bound by 2000. She was originally treated as having multiple sclerosis (MS). She has had multiple rounds of solumedrol, with unclear efficacy on her symptoms. When transferred to care at Barnes-Jewish hospital she was treated with beta-interferon 1b, which was ineffective and caused "lab abnormalities," so she was switched to Copaxone in 2003 and did well. In 2008, she had a blood sample sent to Mayo clinic, and was found to be positive for the NMO-IgG antibody. She never developed optic neuritis.
