Collongues Nicolas, Cabre Philippe, Marignier Romain, Zéphir Hèléne, Papeix Caroline, Audoin Bertrand, Lebrun-Frenay Christine, Pelletier Jean, Fontaine Bertrand, Vermersch Patrick, Confavreux Christian, de Seze Jérôme
Hôpital Universitaire de Strasbourg, Service de Neurologie et Centre d'Investigation Clinique INSERM 1002, Strasbourg, France.
Arch Neurol. 2011 Jul;68(7):918-24. doi: 10.1001/archneurol.2011.127.
Few data exist on a possible benign form of neuromyelitis optica (NMO).
To identify NMO with a good outcome (go-NMO) among a large population of patients and to describe demographic and clinical variables associated with go-NMO vs standard NMO and benign multiple sclerosis.
Observational retrospective multicenter study.
Twenty-five medical centers in metropolitan France (MF) and 3 medical centers in the French West Indies (FWI).
A total of 175 patients with NMO were retrospectively analyzed from 2 cohorts: 125 in MF and 50 patients of nonwhite race/ethnicity in the FWI. Patients in MF fulfilled the 2006 NMO criteria, whereas patients in the FWI fulfilled the 1999 or 2006 NMO criteria. Neuromyelitis optica and multiple sclerosis databases were reviewed, and patients with a score of 3 or lower on the Expanded Disability Status Scale after a 10-year follow-up period were considered to have go-NMO.
Clinical, laboratory, and magnetic resonance imaging data and course of disability.
In MF, go-NMO was observed in 11 patients, including 3 untreated patients. In the FWI, NMO was severe because of disability related to optic neuritis. Compared with standard NMO, go-NMO was associated with a lower annualized relapse rate (0.3 vs 1.0, P < .01), and 8 of 11 patients with go-NMO showed complete regression of myelitis on magnetic resonance imaging during the disease course. Three patients experienced a disabling attack of NMO after 15 years of follow-up. A good outcome occurred less frequently among patients with NMO than among patients with multiple sclerosis (12.0% vs 22.4%, P = .03).
Among patients in MF, go-NMO occurs rarely. However, because a disabling attack may occur after a long follow-up period, a benign form of NMO cannot be defined.
关于视神经脊髓炎（NMO）可能存在的良性形式的数据很少。
在大量患者中识别出预后良好的NMO（go-NMO），并描述与go-NMO、标准NMO和良性多发性硬化相关的人口统计学和临床变量。
观察性回顾性多中心研究。
法国大都市地区的25个医疗中心（MF）和法属西印度群岛的3个医疗中心（FWI）。
从2个队列中对175例NMO患者进行回顾性分析：MF队列中有125例，FWI队列中有50例非白人种族/族裔患者。MF队列中的患者符合2006年NMO标准，而FWI队列中的患者符合1999年或2006年NMO标准。对视神经脊髓炎和多发性硬化数据库进行了回顾，在10年随访期后扩展残疾状态量表评分≤3分的患者被视为go-NMO。
临床、实验室和磁共振成像数据以及残疾病程。
在MF队列中，11例患者被观察到为go-NMO，其中3例未接受治疗。在FWI队列中，由于视神经炎导致的残疾，NMO病情严重。与标准NMO相比，go-NMO的年化复发率较低（0.3对1.0，P<.01），11例go-NMO患者中有8例在病程中磁共振成像显示脊髓炎完全消退。3例患者在随访15年后发生了导致残疾的NMO发作。NMO患者预后良好的情况比多发性硬化患者少见（12.0%对22.4%，P=.03）。
在MF队列的患者中，go-NMO很少见。然而，由于在长期随访后可能发生导致残疾的发作，因此无法定义NMO的良性形式。
