Abstract
We present a case of neuromyelitis optica (NMO) in a previously healthy 64-year-old woman. While CT scan and MRI investigations of the brain as well as myelography were normal, CSF revealed a pathological increase of IgG. Notwithstanding an intensive steroid therapy the patient died after 4 1/2 months. Microscopic examination showed, besides extensive demyelination of the optic nerves and spinal cord (especially in its cervico-dorsal tract), several small demyelinating plaques in the white matter of the pons and near the right lateral ventricle. These findings confirm once again that NMO is a clinical variant of multiple sclerosis and that this disease may make its first appearance at an old age.
Sommario
Viene descritto un caso di neuromielite ottica (NMO) insorta in una donna di 64 anni. Mentre la Tomografia Computerizzata e la Risonanza Magnetica Nucleare a livello encefalico nonché la mielografia risultarono normali, fu invece documentato un aumento patologico delle IgG liquorali. La paziente giunse a morte dopo 4 mesi e mezzo nonostante una intensa terapia steroidea.
L'esame microscopico dimostrò, accanto ad una estesa demielinizzazione dei nervi ottici e del midollo spinale (specialmente nel tratto cervico-dorsale) piccole placche di demielinizzazione disseminate nella sostanza bianca del ponte ed in prossimità del ventricolo laterale destro.
Questi reperti confermano che la NMO è una variante clinica della sclerosi multipla e che può esordire in età avanzata.
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Ghezzi, M., Giansanti, M., Malentacchi, G.M. et al. Neuromyelitis optica in the old age: a clinico-pathological contribution. Ital J Neuro Sci 8, 613–616 (1987). https://doi.org/10.1007/BF02333670
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DOI: https://doi.org/10.1007/BF02333670