Kikumoto Mai, Nonaka Megumi, Takeshita Jun, Ohshita Tomohiko, Yamashita Hiroshi
Department of Neurology, Hiroshima City Asa Citizens Hospital.
Rinsho Shinkeigaku. 2018 Dec 21;58(12):761-763. doi: 10.5692/clinicalneurol.cn-001208. Epub 2018 Nov 29.
We report a case of neuromyelitis optica (NMO) that was diagnosed at the age of 90. After initially developing visual loss in the right eye, a patient was diagnosed with optic neuritis. Although treatment with methylprednisolone therapy provided relief, 3 months later she developed optic neuritis on the other side. Visual activity recovered after further administration of methylprednisolone. At the age of 91, she presented with muscle weakness of her left extremities. A cervical MRI revealed myelitis with a longitudinally extensive spinal cord lesion from the second to fifth cervical vertebrae. Anti-AQP-4 antibody was detected in her serum. She was diagnosed with NMO and treated with methylprednisolone therapy. Subsequently, she repeatedly relapsed within a short period, developing myelitis once and optic neuritis three times within a year. However, during each hospitalization period, methylprednisolone therapy proved to be effective for relieving her symptoms. As NMO patients with onsets over 60 years of the age have been reported, medical practitioners should be aware that disease onset can occur at extremely older ages, such as 90 years old.
我们报告一例90岁时被诊断为视神经脊髓炎（NMO）的病例。患者最初出现右眼视力丧失，被诊断为视神经炎。尽管甲基强的松龙治疗缓解了症状，但3个月后另一侧眼睛又出现了视神经炎。再次给予甲基强的松龙后视力恢复。91岁时，她出现左上肢肌无力。颈椎MRI显示脊髓炎，颈2至颈5椎体有纵向广泛的脊髓病变。血清中检测到抗AQP - 4抗体。她被诊断为NMO并接受甲基强的松龙治疗。随后，她在短时间内反复复发，一年内发生脊髓炎1次，视神经炎3次。然而，在每次住院期间，甲基强的松龙治疗都被证明对缓解她的症状有效。由于已有60岁以上发病的NMO患者的报道，医生应意识到该病可在极高龄时发病，如90岁。
