Komolafe Morenikeji A, Komolafe Edward O, Sunmonu Taofiki A, Olateju S O, Asaleye C M, Adesina Olufemi A, Badmus S A
Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
J Med Case Rep. 2008 Nov 17;2:348. doi: 10.1186/1752-1947-2-348.
Devic's neuromyelitis optica is an inflammatory demyelinating disease that targets the optic nerves and spinal cord. It has a worldwide distribution and distinctive features that distinguish it from multiple sclerosis. There has been no previous report of neuromyelitis optica from our practice environment, and we are not aware of any case associated with antiphospholipid syndrome in an African person.
We report the case of a 28-year-old Nigerian woman who presented with neck pain, paroxysmal tonic spasms, a positive Lhermitte's sign and spastic quadriplegia. She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome. Her initial magnetic resonance imaging showed a central linear hyperintense focus in the intramedullary portion of C2 to C4. Repeat magnetic resonance imaging after treatment revealed resolution of the signal intensity noticed earlier.
Neuromyelitis optica should be considered in the differential diagnoses of acute myelopathy in Africans. We also highlight the unusual association with antiphospholipid syndrome. Physicians should screen such patients for autoimmune disorders.
视神经脊髓炎是一种针对视神经和脊髓的炎性脱髓鞘疾病。它在全球范围内均有分布，具有与多发性硬化症不同的独特特征。在我们的医疗环境中，此前尚无视神经脊髓炎的报告，而且我们也不知道有任何非洲人患视神经脊髓炎与抗磷脂综合征相关的病例。
我们报告了一名28岁尼日利亚女性的病例，该患者出现颈部疼痛、阵发性强直性痉挛、莱尔米特征阳性及痉挛性四肢瘫。她后来发展为双侧视神经炎，并具有抗磷脂综合征的临床和生化特征。其最初的磁共振成像显示C2至C4髓内部分有一个中央线性高信号灶。治疗后的重复磁共振成像显示先前发现的信号强度消失。
在非洲人急性脊髓病的鉴别诊断中应考虑视神经脊髓炎。我们还强调了其与抗磷脂综合征的不寻常关联。医生应对此类患者进行自身免疫性疾病筛查。
