Department of Pediatrics, Division of Child Neurology, Kocaeli University Medical Faculty, Umuttepe, Turkey.
Pediatr Neurol. 2013 Sep;49(3):198-202. doi: 10.1016/j.pediatrneurol.2013.02.008. Epub 2013 Jul 4.
Neuromyelitis optica is an autoimmune demyelinating disorder of the central nervous system. Although it has some features in common with multiple sclerosis, it has different clinical features, prognosis, and treatment. We describe a boy with seropositive neuromyelitis optica and his 6-year follow-up.
A boy aged 5 years 8 months presented with relapsing optic neuritis, short segment transverse myelitis, and brain involvement. He met the diagnostic criteria for multiple sclerosis fulfilling the McDonald 2010 criteria; however, neuromyelitis optica immunoglobulin-G was detected, and the patient was diagnosed with neuromyelitis optica. He had frequent relapses until immunosuppressive treatment with azathioprine and low-dose prednisone was started. After he was asymptomatic for 2.5 years, prednisone was withdrawn, but he had a new attack soon after withdrawal of the steroid.
It is important to differentiate neuromyelitis optica from multiple sclerosis because early immunosuppressive treatment prevents further disability, and longer periods of immunosuppressive treatment should be planned to prevent relapses.
视神经脊髓炎是一种中枢神经系统自身免疫性脱髓鞘疾病。虽然它与多发性硬化症有一些共同特征，但具有不同的临床特征、预后和治疗方法。我们描述了一名血清阳性视神经脊髓炎男孩及其 6 年随访情况。
一名 5 岁 8 个月大的男孩出现复发性视神经炎、短节段横贯性脊髓炎和脑部受累。他符合多发性硬化症的诊断标准，符合 McDonald 2010 标准；然而，检测到视神经脊髓炎免疫球蛋白-G，诊断为视神经脊髓炎。他频繁复发，直到开始使用硫唑嘌呤和低剂量泼尼松进行免疫抑制治疗。他无症状 2.5 年后停用泼尼松，但停用类固醇后不久即出现新的发作。
区分视神经脊髓炎和多发性硬化症很重要，因为早期免疫抑制治疗可防止进一步残疾，应计划更长时间的免疫抑制治疗以预防复发。
